Limits...
Positive Association of Fibroadenomatoid Change with HER2-Negative Invasive Breast Cancer: A Co-Occurrence Study.

Chen Y, Bekhash A, Kovatich AJ, Hooke JA, Liu J, Kvecher L, Fantacone-Campbell JL, Mitchell EP, Rui H, Mural RJ, Shriver CD, Hu H - PLoS ONE (2015)

Bottom Line: Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC.This association is only significant with HER2-negative IBC subtypes.We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA.

View Article: PubMed Central - PubMed

Affiliation: Biomedical Informatics, Windber Research Institute, Windber, Pennsylvania, United States of America.

ABSTRACT

Background: Risk assessment of a benign breast disease/lesion (BBD) for invasive breast cancer (IBC) is typically done through a longitudinal study. For an infrequently-reported BBD, the shortage of occurrence data alone is a limiting factor to conducting such a study. Here we present an approach based on co-occurrence analysis, to help address this issue. We focus on fibroadenomatoid change (FAC), an under-studied BBD, as our preliminary analysis has suggested its previously unknown significant co-occurrence with IBC.

Methods: A cohort of 1667 female patients enrolled in the Clinical Breast Care Project was identified. A single experienced breast pathologist reviewed all pathology slides for each case and recorded all observed lesions, including FAC. Fibroadenoma (FA) was studied for comparison since FAC had been speculated to be an immature FA. FA and Fibrocystic Changes (FCC) were used for method validation since they have been comprehensively studied. Six common IBC and BBD risk/protective factors were also studied. Co-occurrence analyses were performed using logistic regression models.

Results: Common risk/protective factors were associated with FA, FCC, and IBC in ways consistent with the literature in general, and they were associated with FAC, FA, and FCC in distinct patterns. Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC. We report for the first time that FAC is positively associated with IBC with odds ratio (OR) depending on BMI (OR = 6.78, 95%CI = 3.43-13.42 at BMI<25 kg/m2; OR = 2.13, 95%CI = 1.20-3.80 at BMI>25 kg/m2). This association is only significant with HER2-negative IBC subtypes.

Conclusions: We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA. Co-occurrence analysis can be used for initial assessment of the risk for IBC from a BBD, which is vital to the study of infrequently-reported BBDs.

No MeSH data available.


Related in: MedlinePlus

Histological images of FAC, FA, and FCC.Original magnification: 200x. (A) FAC. Multiple miniature fibroadenoma-like nodules are intimately associated with an invasive lobular carcinoma. Unlike an FA, the lesion is microscopic and not well-defined. (B) A portion of a typical FA. The lesion is well-circumscribed, has a fibrous capsule, and displays proliferation of both glandular and stromal elements. The elongated, branching epithelial glands are characteristic of FA. (C) FCC. This section of breast tissue exhibits many elements of FCC including stromal fibrosis, microcysts, apocrine metaplasia, sclerosing adenosis, and usual intraductal hyperplasia. The patient had ductal carcinoma in situ on other tissue sections.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4476726&req=5

pone.0129500.g002: Histological images of FAC, FA, and FCC.Original magnification: 200x. (A) FAC. Multiple miniature fibroadenoma-like nodules are intimately associated with an invasive lobular carcinoma. Unlike an FA, the lesion is microscopic and not well-defined. (B) A portion of a typical FA. The lesion is well-circumscribed, has a fibrous capsule, and displays proliferation of both glandular and stromal elements. The elongated, branching epithelial glands are characteristic of FA. (C) FCC. This section of breast tissue exhibits many elements of FCC including stromal fibrosis, microcysts, apocrine metaplasia, sclerosing adenosis, and usual intraductal hyperplasia. The patient had ductal carcinoma in situ on other tissue sections.

Mentions: From a total of 3503 CBCP subjects with a pathology checklist, 1667 were eligible for this study (Fig 1). There were 619 cases with an IBC, and 1048 controls with benign disease. Representative pathologic images of FAC, FA, and FCC are shown in Fig 2.


Positive Association of Fibroadenomatoid Change with HER2-Negative Invasive Breast Cancer: A Co-Occurrence Study.

Chen Y, Bekhash A, Kovatich AJ, Hooke JA, Liu J, Kvecher L, Fantacone-Campbell JL, Mitchell EP, Rui H, Mural RJ, Shriver CD, Hu H - PLoS ONE (2015)

Histological images of FAC, FA, and FCC.Original magnification: 200x. (A) FAC. Multiple miniature fibroadenoma-like nodules are intimately associated with an invasive lobular carcinoma. Unlike an FA, the lesion is microscopic and not well-defined. (B) A portion of a typical FA. The lesion is well-circumscribed, has a fibrous capsule, and displays proliferation of both glandular and stromal elements. The elongated, branching epithelial glands are characteristic of FA. (C) FCC. This section of breast tissue exhibits many elements of FCC including stromal fibrosis, microcysts, apocrine metaplasia, sclerosing adenosis, and usual intraductal hyperplasia. The patient had ductal carcinoma in situ on other tissue sections.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4476726&req=5

pone.0129500.g002: Histological images of FAC, FA, and FCC.Original magnification: 200x. (A) FAC. Multiple miniature fibroadenoma-like nodules are intimately associated with an invasive lobular carcinoma. Unlike an FA, the lesion is microscopic and not well-defined. (B) A portion of a typical FA. The lesion is well-circumscribed, has a fibrous capsule, and displays proliferation of both glandular and stromal elements. The elongated, branching epithelial glands are characteristic of FA. (C) FCC. This section of breast tissue exhibits many elements of FCC including stromal fibrosis, microcysts, apocrine metaplasia, sclerosing adenosis, and usual intraductal hyperplasia. The patient had ductal carcinoma in situ on other tissue sections.
Mentions: From a total of 3503 CBCP subjects with a pathology checklist, 1667 were eligible for this study (Fig 1). There were 619 cases with an IBC, and 1048 controls with benign disease. Representative pathologic images of FAC, FA, and FCC are shown in Fig 2.

Bottom Line: Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC.This association is only significant with HER2-negative IBC subtypes.We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA.

View Article: PubMed Central - PubMed

Affiliation: Biomedical Informatics, Windber Research Institute, Windber, Pennsylvania, United States of America.

ABSTRACT

Background: Risk assessment of a benign breast disease/lesion (BBD) for invasive breast cancer (IBC) is typically done through a longitudinal study. For an infrequently-reported BBD, the shortage of occurrence data alone is a limiting factor to conducting such a study. Here we present an approach based on co-occurrence analysis, to help address this issue. We focus on fibroadenomatoid change (FAC), an under-studied BBD, as our preliminary analysis has suggested its previously unknown significant co-occurrence with IBC.

Methods: A cohort of 1667 female patients enrolled in the Clinical Breast Care Project was identified. A single experienced breast pathologist reviewed all pathology slides for each case and recorded all observed lesions, including FAC. Fibroadenoma (FA) was studied for comparison since FAC had been speculated to be an immature FA. FA and Fibrocystic Changes (FCC) were used for method validation since they have been comprehensively studied. Six common IBC and BBD risk/protective factors were also studied. Co-occurrence analyses were performed using logistic regression models.

Results: Common risk/protective factors were associated with FA, FCC, and IBC in ways consistent with the literature in general, and they were associated with FAC, FA, and FCC in distinct patterns. Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC. We report for the first time that FAC is positively associated with IBC with odds ratio (OR) depending on BMI (OR = 6.78, 95%CI = 3.43-13.42 at BMI<25 kg/m2; OR = 2.13, 95%CI = 1.20-3.80 at BMI>25 kg/m2). This association is only significant with HER2-negative IBC subtypes.

Conclusions: We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA. Co-occurrence analysis can be used for initial assessment of the risk for IBC from a BBD, which is vital to the study of infrequently-reported BBDs.

No MeSH data available.


Related in: MedlinePlus