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American Journal of Epidemiology Vol. 137, No. 8: 829-833
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Breast Cancer Risk Associated with Abnormal Cytology in Nipple Aspirates of Breast Fluid and Prior History of Breast Biopsy

Margaret Wrensch, Nicholas L. Petrakis, Eileen B. King, Marion M. Lee and Rei Miike

From the Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, CA

Reprint requests to Dr. Margaret Wrensch, Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, CA 94143-0560.

The authors previously reported an increased risk of breast cancer in women from the San Francisco Bay Area first enrolled between 1973 and 1980 with proliferative cytologic findings (hyperplasia, moderate hyperplasia, and atypia) compared with women with normal cytologic findings in breast fluids obtained by nipple aspiration and with women from whom breast fluid could not be obtained. To look for factors which might modify the risks associated with cytology, the authors examined several standard breast cancer risk factors: parity, age at first pregnancy, age at menarche, family history of breast cancer, and prior history of breast biopsy. Among women aged 30 years or over, only prior biopsy modified the effect of proliferative cytologic findings on the risk of breast cancer (p<0.10). For those women with no prior biopsy, breast cancer incidence was 5% (47 of 985) among women with normal cytology and 5% (13 of 277) among women with proliferative findings, whereas among those women with prior biopsy, breast cancer incidence was 4% (eight of 185) among women with normal cytology and 18% (11 of 62) among women with proliferative cytology. Age-adjusted as well as multivariate-adjusted relative risks indicated that the increased risk of breast cancer associated with proliferative cytologic findings was largely confined to women who had a prior history of breast biopsy.

biopsy; breast; breast neoplasms; cohort studies; cytology; risk factors


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