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Trajectory of Subsequent Breast Cancer Diagnoses in a Diverse Patient Cohort with Breast Atypia.

Publication ,  Journal Article
Limberg, JN; Thomas, SM; Dalton, JC; Ntowe, KW; Nash, AL; Chiba, A; Plichta, JK; Hwang, ES
Published in: Ann Surg Oncol
July 21, 2024

BACKGROUND: Proliferative breast atypical lesions, including atypical ductal hyperplasia (ADH) and lobular intraepithelial neoplasms (LIN), represent benign entities that confer an elevated risk of ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC). However, the timing of disease progression is variable and risk factors associated with the trajectory of disease are unknown. METHODS: Patients diagnosed with ADH or LIN from 1992 to 2017 at an academic center were identified. Early progression was defined as DCIS or IBC diagnosed within 5 years following the initial atypia diagnosis. Unadjusted cancer-free survival was estimated using the Kaplan-Meier method. Demographics, clinicopathologic features, and use of chemoprevention were compared between the early and late development groups. RESULTS: Overall, 418 patients were included-73.7% with ADH and 26.3% with LIN. Over a median follow up of 92.1 months, 71/418 (17.0%) patients developed IBC (57.7%) or DCIS (42.3%). Almost half (47.9%, 34/71) were diagnosed within 5 years of their initial atypia diagnosis, and 52.1% (37/71) were diagnosed after 5 years. Patient and atypia characteristics were not associated with rate of events or time to events. There was a trend of early events being more often ipsilateral (76.5% early vs. 54.1% late; p = 0.13) versus contralateral. CONCLUSIONS: In a large cohort of patients with breast atypia and long-term follow up, 17% experienced subsequent breast events, with approximately half of the events occurring within the first 5 years following the initial atypia diagnosis. Clinical features were not associated with the trajectory to subsequent events, supporting that atypia signals both local and overall malignancy risk.

Duke Scholars

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

July 21, 2024

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

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Limberg, J. N., Thomas, S. M., Dalton, J. C., Ntowe, K. W., Nash, A. L., Chiba, A., … Hwang, E. S. (2024). Trajectory of Subsequent Breast Cancer Diagnoses in a Diverse Patient Cohort with Breast Atypia. Ann Surg Oncol. https://doi.org/10.1245/s10434-024-15788-7
Limberg, Jessica N., Samantha M. Thomas, Juliet C. Dalton, Koumani W. Ntowe, Amanda L. Nash, Akiko Chiba, Jennifer K. Plichta, and E Shelley Hwang. “Trajectory of Subsequent Breast Cancer Diagnoses in a Diverse Patient Cohort with Breast Atypia.Ann Surg Oncol, July 21, 2024. https://doi.org/10.1245/s10434-024-15788-7.
Limberg JN, Thomas SM, Dalton JC, Ntowe KW, Nash AL, Chiba A, et al. Trajectory of Subsequent Breast Cancer Diagnoses in a Diverse Patient Cohort with Breast Atypia. Ann Surg Oncol. 2024 Jul 21;
Limberg, Jessica N., et al. “Trajectory of Subsequent Breast Cancer Diagnoses in a Diverse Patient Cohort with Breast Atypia.Ann Surg Oncol, July 2024. Pubmed, doi:10.1245/s10434-024-15788-7.
Limberg JN, Thomas SM, Dalton JC, Ntowe KW, Nash AL, Chiba A, Plichta JK, Hwang ES. Trajectory of Subsequent Breast Cancer Diagnoses in a Diverse Patient Cohort with Breast Atypia. Ann Surg Oncol. 2024 Jul 21;
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

July 21, 2024

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis