Breast Cancer and Benign Associated Breast Conditions: A systematic review of records
AUTHORS: F. Fadlalla, H. Gad, M. Ramadan, I. Seifeldin, A. Hablas, A. Soliman, L. Rozek.
Women with a previous diagnosis of benign breast disease, especially those diagnosed earlier in life with a proliferative condition, may have a higher risk for developing breast cancer later on in life. Previous studies have shown that the risk for developing breast cancer in women with a previous diagnosis of a benign breast disease is between 1.83-2.7. The objective of this study was to evaluate the relationship between benign breast disease and subsequent diagnosis of breast cancer in a population-based registry in Egypt.
Using the Tanta Cancer Center Registry (TCC), we identified all women diagnosed with breast cancer from 2002-2006 with a histopathological confirmation of invasive ductal carcinoma (IDC). Pathology reports were reviewed to determine the proportion of women with IDC and a previous benign condition including: fibroadenoma, fibrocystic disease, atypical hyperplasia, adenosis, and intraductal papillomas. Laboratory reports from a private pathology laboratory (Dr. Sheriff Bayoumy) were also evaluated for comparison to the pathology reports from the registry. Clinicopathologic characteristics, including estrogen receptor (ER) status and stage, were collected for comparison with women with IDC and no previous record of a benign condition.
We identified 1,375 women with a diagnosis of IDC and a pathology report available from TCC. The prevalence of benign conditions recorded in the pathology report was low in this population. Rates of reporting were similar for TCC and the private pathology lab (1.45% and 3.66%, respectively). A lack of comprehensive medical history proved a serious limitation to ascertaining previous history of benign conditions.
The rate of benign breast conditions preceding breast cancer was 1.45% in the registry and 3.66% in the private laboratory. An effective means of ascertaining the association between benign breast conditions and the development of breast cancer would be through a prospective study of women with diagnosed benign disease. A similar study may be better conducted in an environment with high screening rates and linked pathology records . The process of record review in an international setting allows one to truly become familiarized with the health information system of that specific country.
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