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JNCI Journal of the National Cancer Institute 2006 98(22):1600-1607; doi:10.1093/jnci/djj439
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© 2006 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ARTICLE

Age-Related Lobular Involution and Risk of Breast Cancer

Tia R. Milanese, Lynn C. Hartmann, Thomas A. Sellers, Marlene H. Frost, Robert A. Vierkant, Shaun D. Maloney, V. Shane Pankratz, Amy C. Degnim, Celine M. Vachon, Carol A. Reynolds, Romayne A. Thompson, L. Joseph Melton, III, Ellen L. Goode, Daniel W. Visscher

Affiliations of authors: Mayo Medical School (TRM), Division of Medical Oncology (LCH, MHF, RAT), Division of Epidemiology (CMV, LJM, ELG), Division of Biostatistics (RAV, SDM, VSP), Division of General Surgery (ACD), and Division of Anatomic Pathology (CAR, DWV), Mayo Clinic, College of Medicine, Rochester, MN; Department of Cancer Prevention and Control, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (TAS)

Correspondence to: Lynn C. Hartmann, MD, Department of Oncology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55905 (e-mail: hartmann.lynn{at}mayo.edu).

Background: As women age, the lobules in their breasts undergo involution or regression. We investigated whether lobular involution in women with benign breast disease was associated with subsequent breast cancer risk. Methods: We examined biopsy specimens of 8736 women in the Mayo Benign Breast Disease Cohort from whom biopsy samples were taken between January 1, 1967, and December 31, 1991. Median follow-up for breast cancer outcomes was 17 years. We classified lobular involution in the background breast tissue as none (0% involuted lobules), partial (1%–74%), or complete (≥75%). Subsequent breast cancer events and data on other risk factors were obtained from medical records and follow-up questionnaires. To estimate relative risks (RRs), standardized incidence ratios were calculated by use of incidence rates from the Iowa Surveillance, Epidemiology, and End Results (SEER) Registry. All statistical tests were two-sided. Results: Distribution of extent of involution was none among 1627 (18.6%) women, partial among 5197 (59.5%), and complete among 1912 (21.9%). Increased involution was positively associated with increased age and inversely associated with parity (both P<.001). The relative risk for the entire cohort of 8736 women, compared with the Iowa SEER population, was 1.40 (95% CI = 1.30 to 1.51). Risk of breast cancer was associated with the extent of involution (for no involution, RR [i.e., observed versus expected] = 1.88, 95% confidence interval [CI] = 1.59 to 2.21; for partial involution, RR = 1.47, 95% CI = 1.33 to 1.61; and for complete involution, RR = 0.91, 95% CI = 0.75 to 1.10; test for heterogeneity P<.001). Lobular involution modified risk in all subsets (e.g., among women with atypia, for no involution, RR = 7.79, 95% CI = 3.56 to 14.81; for partial involution, RR = 4.06, 95% CI = 3.03 to 5.33; and for complete involution, RR = 1.49, 95% CI = 0.41 to 3.82; P = .003). Conclusions: In this large cohort of women with benign breast disease, lobular involution was associated with reduced risk of breast cancer. Aberrant involution may be a biologically important phenomenon in breast cancer biology.


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Correspondence about this Article

Re: Age-Related Lobular Involution and Risk of Breast Cancer
Gianluigi Ferretti, Alessandra Felici, and Francesco Cognetti
J Natl Cancer Inst 2007 99: 571-572. [Extract] [Full Text] [PDF]



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