在皮肤活检时代,良性乳腺疾病和乳腺癌风险
Mark E Sherman1, Robert A Vierkant2, Stacey J Winham2
1Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida.
JAMA surgery
|December 13, 2023
概括
通过皮肤活检诊断出良性乳腺疾病 (BBD) 的妇女面临乳腺癌 (BC) 的风险增加,类似于历史的外科活检发现. 对BBD严重程度和多重性的病理分类可以改善BC风险评估.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 流行病学 流行病学
背景情况:
- 良性乳腺疾病 (BBD) 在乳腺活检中很常见,已知特定诊断 (非增殖性,无缺陷的增殖性疾病,非典型的增生症) 与乳腺癌 (BC) 风险增加之间存在关联.
- 有限的数据存在于BC风险与BBD通过皮肤活检诊断,这是当前时代常见的诊断方法.
研究的目的:
- 在被诊断为良性乳腺疾病 (BBD) 的妇女中,通过皮肤活检估计患乳腺癌 (BC) 的风险.
- 通过皮肤活检队列中的BC风险与一般人口的发病率和历史的外科活检数据进行比较.
主要方法:
- 一项回顾性队列研究分析了2002年至2013年期间诊断的4819名妇女的BBD活检样本.
- 病理学审查分类BBD严重程度和多重性;妇女被跟踪到2021年12月的BC诊断.
- 评估乳腺癌风险是使用Cox比例危险回归,并与爱荷华州SEER计划数据进行比较.
主要成果:
- 与普通人群相比,患有BBD的队列显示总体BC (SIR,1.95),侵入性BC (SIR,1.56) 和管道癌 in situ (DCIS) (SIR,3.10) 的风险显著增加.
- 风险随着BBD的严重程度 (非增殖性,增殖性疾病没有异型,异型增殖) 和病变的多重性而增加.
- 与预期的人口发病率相比,所有BBD类别的十年累积BC发病率都更高.
结论:
- 通过皮肤诊断的良性乳腺疾病 (BBD) 与乳腺癌 (BC) 的风险增加有关,与历史外科活检队列的发现相似.
- 考虑到病变的严重程度和多重性,BBD的病理分类为改善临床实践中的BC风险分层提供了潜在的潜力.
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