Benign breast disease increases breast cancer risk independent of underlying familial risk profile: Findings from a Prospective Family Study Cohort

Nur Zeinomar, Kelly Anne Phillips, Mary B. Daly, Roger L. Milne, Gillian S. Dite, Robert J. MacInnis, Yuyan Liao, Rebecca D. Kehm, Julia A. Knight, Melissa C. Southey, Wendy K. Chung, Graham G. Giles, Sue Anne McLachlan, Michael L. Friedlander, Prue C. Weideman, Gord Glendon, Stephanie Nesci, kConFab Investigators, Irene L. Andrulis, Saundra S. Buys & 3 others Esther M. John, John L. Hopper, Mary Beth Terry

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Benign breast disease (BBD) is an established breast cancer (BC) risk factor, but it is unclear whether the magnitude of the association applies to women at familial or genetic risk. This information is needed to improve BC risk assessment in clinical settings. Using the Prospective Family Study Cohort, we used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of BBD with BC risk. We also examined whether the association with BBD differed by underlying familial risk profile (FRP), calculated using absolute risk estimates from the Breast Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) model. During 176,756 person-years of follow-up (median: 10.9 years, maximum: 23.7) of 17,154 women unaffected with BC at baseline, we observed 968 incident cases of BC. A total of 4,704 (27%) women reported a history of BBD diagnosis at baseline. A history of BBD was associated with a greater risk of BC: HR = 1.31 (95% CI: 1.14–1.50), and did not differ by underlying FRP, with HRs of 1.35 (95% CI: 1.11–1.65), 1.26 (95% CI: 1.00–1.60), and 1.40 (95% CI: 1.01–1.93), for categories of full-lifetime BOADICEA score <20%, 20 to <35%, ≥35%, respectively. There was no difference in the association for women with BRCA1 mutations (HR: 1.64; 95% CI: 1.04–2.58), women with BRCA2 mutations (HR: 1.34; 95% CI: 0.78–2.3) or for women without a known BRCA1 or BRCA2 mutation (HR: 1.31; 95% CI: 1.13–1.53) (p interaction = 0.95). Women with a history of BBD have an increased risk of BC that is independent of, and multiplies, their underlying familial and genetic risk.

Original languageEnglish
Number of pages10
JournalInternational Journal of Cancer
DOIs
Publication statusPublished - 1 Jan 2019
Externally publishedYes

Keywords

  • benign breast disease
  • Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm
  • breast cancer
  • familial risk

Cite this

Zeinomar, Nur ; Phillips, Kelly Anne ; Daly, Mary B. ; Milne, Roger L. ; Dite, Gillian S. ; MacInnis, Robert J. ; Liao, Yuyan ; Kehm, Rebecca D. ; Knight, Julia A. ; Southey, Melissa C. ; Chung, Wendy K. ; Giles, Graham G. ; McLachlan, Sue Anne ; Friedlander, Michael L. ; Weideman, Prue C. ; Glendon, Gord ; Nesci, Stephanie ; kConFab Investigators ; Andrulis, Irene L. ; Buys, Saundra S. ; John, Esther M. ; Hopper, John L. ; Terry, Mary Beth. / Benign breast disease increases breast cancer risk independent of underlying familial risk profile : Findings from a Prospective Family Study Cohort. In: International Journal of Cancer. 2019.
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title = "Benign breast disease increases breast cancer risk independent of underlying familial risk profile: Findings from a Prospective Family Study Cohort",
abstract = "Benign breast disease (BBD) is an established breast cancer (BC) risk factor, but it is unclear whether the magnitude of the association applies to women at familial or genetic risk. This information is needed to improve BC risk assessment in clinical settings. Using the Prospective Family Study Cohort, we used Cox proportional hazards models to estimate hazard ratios (HRs) and 95{\%} confidence intervals (CIs) for the association of BBD with BC risk. We also examined whether the association with BBD differed by underlying familial risk profile (FRP), calculated using absolute risk estimates from the Breast Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) model. During 176,756 person-years of follow-up (median: 10.9 years, maximum: 23.7) of 17,154 women unaffected with BC at baseline, we observed 968 incident cases of BC. A total of 4,704 (27{\%}) women reported a history of BBD diagnosis at baseline. A history of BBD was associated with a greater risk of BC: HR = 1.31 (95{\%} CI: 1.14–1.50), and did not differ by underlying FRP, with HRs of 1.35 (95{\%} CI: 1.11–1.65), 1.26 (95{\%} CI: 1.00–1.60), and 1.40 (95{\%} CI: 1.01–1.93), for categories of full-lifetime BOADICEA score <20{\%}, 20 to <35{\%}, ≥35{\%}, respectively. There was no difference in the association for women with BRCA1 mutations (HR: 1.64; 95{\%} CI: 1.04–2.58), women with BRCA2 mutations (HR: 1.34; 95{\%} CI: 0.78–2.3) or for women without a known BRCA1 or BRCA2 mutation (HR: 1.31; 95{\%} CI: 1.13–1.53) (p interaction = 0.95). Women with a history of BBD have an increased risk of BC that is independent of, and multiplies, their underlying familial and genetic risk.",
keywords = "benign breast disease, Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm, breast cancer, familial risk",
author = "Nur Zeinomar and Phillips, {Kelly Anne} and Daly, {Mary B.} and Milne, {Roger L.} and Dite, {Gillian S.} and MacInnis, {Robert J.} and Yuyan Liao and Kehm, {Rebecca D.} and Knight, {Julia A.} and Southey, {Melissa C.} and Chung, {Wendy K.} and Giles, {Graham G.} and McLachlan, {Sue Anne} and Friedlander, {Michael L.} and Weideman, {Prue C.} and Gord Glendon and Stephanie Nesci and {kConFab Investigators} and Andrulis, {Irene L.} and Buys, {Saundra S.} and John, {Esther M.} and Hopper, {John L.} and Terry, {Mary Beth}",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/ijc.32112",
language = "English",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Blackwell",

}

Zeinomar, N, Phillips, KA, Daly, MB, Milne, RL, Dite, GS, MacInnis, RJ, Liao, Y, Kehm, RD, Knight, JA, Southey, MC, Chung, WK, Giles, GG, McLachlan, SA, Friedlander, ML, Weideman, PC, Glendon, G, Nesci, S, kConFab Investigators, Andrulis, IL, Buys, SS, John, EM, Hopper, JL & Terry, MB 2019, 'Benign breast disease increases breast cancer risk independent of underlying familial risk profile: Findings from a Prospective Family Study Cohort' International Journal of Cancer. https://doi.org/10.1002/ijc.32112

Benign breast disease increases breast cancer risk independent of underlying familial risk profile : Findings from a Prospective Family Study Cohort. / Zeinomar, Nur; Phillips, Kelly Anne; Daly, Mary B.; Milne, Roger L.; Dite, Gillian S.; MacInnis, Robert J.; Liao, Yuyan; Kehm, Rebecca D.; Knight, Julia A.; Southey, Melissa C.; Chung, Wendy K.; Giles, Graham G.; McLachlan, Sue Anne; Friedlander, Michael L.; Weideman, Prue C.; Glendon, Gord; Nesci, Stephanie; kConFab Investigators; Andrulis, Irene L.; Buys, Saundra S.; John, Esther M.; Hopper, John L.; Terry, Mary Beth.

In: International Journal of Cancer, 01.01.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Benign breast disease increases breast cancer risk independent of underlying familial risk profile

T2 - Findings from a Prospective Family Study Cohort

AU - Zeinomar, Nur

AU - Phillips, Kelly Anne

AU - Daly, Mary B.

AU - Milne, Roger L.

AU - Dite, Gillian S.

AU - MacInnis, Robert J.

AU - Liao, Yuyan

AU - Kehm, Rebecca D.

AU - Knight, Julia A.

AU - Southey, Melissa C.

AU - Chung, Wendy K.

AU - Giles, Graham G.

AU - McLachlan, Sue Anne

AU - Friedlander, Michael L.

AU - Weideman, Prue C.

AU - Glendon, Gord

AU - Nesci, Stephanie

AU - kConFab Investigators

AU - Andrulis, Irene L.

AU - Buys, Saundra S.

AU - John, Esther M.

AU - Hopper, John L.

AU - Terry, Mary Beth

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Benign breast disease (BBD) is an established breast cancer (BC) risk factor, but it is unclear whether the magnitude of the association applies to women at familial or genetic risk. This information is needed to improve BC risk assessment in clinical settings. Using the Prospective Family Study Cohort, we used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of BBD with BC risk. We also examined whether the association with BBD differed by underlying familial risk profile (FRP), calculated using absolute risk estimates from the Breast Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) model. During 176,756 person-years of follow-up (median: 10.9 years, maximum: 23.7) of 17,154 women unaffected with BC at baseline, we observed 968 incident cases of BC. A total of 4,704 (27%) women reported a history of BBD diagnosis at baseline. A history of BBD was associated with a greater risk of BC: HR = 1.31 (95% CI: 1.14–1.50), and did not differ by underlying FRP, with HRs of 1.35 (95% CI: 1.11–1.65), 1.26 (95% CI: 1.00–1.60), and 1.40 (95% CI: 1.01–1.93), for categories of full-lifetime BOADICEA score <20%, 20 to <35%, ≥35%, respectively. There was no difference in the association for women with BRCA1 mutations (HR: 1.64; 95% CI: 1.04–2.58), women with BRCA2 mutations (HR: 1.34; 95% CI: 0.78–2.3) or for women without a known BRCA1 or BRCA2 mutation (HR: 1.31; 95% CI: 1.13–1.53) (p interaction = 0.95). Women with a history of BBD have an increased risk of BC that is independent of, and multiplies, their underlying familial and genetic risk.

AB - Benign breast disease (BBD) is an established breast cancer (BC) risk factor, but it is unclear whether the magnitude of the association applies to women at familial or genetic risk. This information is needed to improve BC risk assessment in clinical settings. Using the Prospective Family Study Cohort, we used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of BBD with BC risk. We also examined whether the association with BBD differed by underlying familial risk profile (FRP), calculated using absolute risk estimates from the Breast Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) model. During 176,756 person-years of follow-up (median: 10.9 years, maximum: 23.7) of 17,154 women unaffected with BC at baseline, we observed 968 incident cases of BC. A total of 4,704 (27%) women reported a history of BBD diagnosis at baseline. A history of BBD was associated with a greater risk of BC: HR = 1.31 (95% CI: 1.14–1.50), and did not differ by underlying FRP, with HRs of 1.35 (95% CI: 1.11–1.65), 1.26 (95% CI: 1.00–1.60), and 1.40 (95% CI: 1.01–1.93), for categories of full-lifetime BOADICEA score <20%, 20 to <35%, ≥35%, respectively. There was no difference in the association for women with BRCA1 mutations (HR: 1.64; 95% CI: 1.04–2.58), women with BRCA2 mutations (HR: 1.34; 95% CI: 0.78–2.3) or for women without a known BRCA1 or BRCA2 mutation (HR: 1.31; 95% CI: 1.13–1.53) (p interaction = 0.95). Women with a history of BBD have an increased risk of BC that is independent of, and multiplies, their underlying familial and genetic risk.

KW - benign breast disease

KW - Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm

KW - breast cancer

KW - familial risk

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