Skip to main content
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1981 Feb 1;124(3):283–291.

Risk factors for benign breast disease: a 30-year cohort study.

T G Hislop, J M Elwood
PMCID: PMC1705125  PMID: 7459788

Abstract

Data on the menstrual history, family history and degree of obesity of 1374 Vancouver nursing students were collected in 1945 and from 1947 to 1956. In 1979, 768 of these women were located; 726 (94%) responded and participated in a follow-up study, providing information on their subsequent medical history and on breast-related problems. No major differences were found between the early histories of these participants and those who were not located or did not respond. Among the respondents 215 gave a history of symptoms compatible with benign breast disease; in 107 this diagnosis was confirmed by biopsy. By age 50 the cumulative risk for benign breast disease was 17% for biopsied and 31% for symptomatic disease. Biopsied benign breast disease was associated with premenstrual breast discomfort, irregular menses, a history of abortions, a family history of both benign and malignant breast disease, lack of use of oral contraceptives, a low index of obesity and small breasts, obesity and breast size being independent. Factors associated with symptomatic benign breast disease were usually associated with a greater likelihood of biopsy for symptomatic disease; hence, the relative risks for biopsied disease were generally greater than those for symptomatic disease. Although the risk factors for benign breast disease differ from those for breast cancer, the findings are consistent with the hypothesis of excessive circulating estrogen.

Full text

PDF
283

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Black M. M., Barclay T. H., Cutler S. J., Hankey B. F., Asire A. J. Association of atypical characteristics of benign breast lesions with subsequent risk of breast cancer. Cancer. 1972 Feb;29(2):338–343. doi: 10.1002/1097-0142(197202)29:2<338::aid-cncr2820290212>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  2. Bäckström T., Carstensen H. Estrogen and progesterone in plasma in relation to premenstrual tension. J Steroid Biochem. 1974 May;5(3):257–260. doi: 10.1016/0022-4731(74)90139-3. [DOI] [PubMed] [Google Scholar]
  3. Bässler R. The morphology of hormone induced structural changes in the female breast. Curr Top Pathol. 1970;53:1–89. doi: 10.1007/978-3-662-30514-0_1. [DOI] [PubMed] [Google Scholar]
  4. COWIE A. T., FOLLEY S. J., MALPRESS F. H., RICHARDSON K. C. Studies on the hormonal induction of mammary growth and lactation in the goat. J Endocrinol. 1952 Jan;8(1):64–88. doi: 10.1677/joe.0.0080064. [DOI] [PubMed] [Google Scholar]
  5. Coldman A. J., Elwood J. M. Examining survival data. Can Med Assoc J. 1979 Oct 20;121(8):1065-8, 1071. [PMC free article] [PubMed] [Google Scholar]
  6. Cole P. T. Oral contraceptives and breast neoplasia. Cancer. 1977 Apr;39(4 Suppl):1906–1908. doi: 10.1002/1097-0142(197704)39:4+<1906::aid-cncr2820390827>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  7. Cole P., Mark Elwood J., Kaplan S. D. Incidence rates and risk factors of benign breast neoplasms. Am J Epidemiol. 1978 Aug;108(2):112–120. doi: 10.1093/oxfordjournals.aje.a112594. [DOI] [PubMed] [Google Scholar]
  8. Donnelly P. K., Baker K. W., Carney J. A., O'Fallon W. M. Benign breast lesions and subsequent breast carcinoma in Rochester, Minnesota. Mayo Clin Proc. 1975 Nov;50(11):650–656. [PubMed] [Google Scholar]
  9. Fasal E., Paffenbarger R. S., Jr Oral contraceptives as related to cancer and benign lesions of the breast. J Natl Cancer Inst. 1975 Oct;55(4):767–773. doi: 10.1093/jnci/55.4.767. [DOI] [PubMed] [Google Scholar]
  10. Haagensen C. D. The relationship of gross cystic disease of the breast and carcinoma. Ann Surg. 1977 Mar;185(3):375–376. doi: 10.1097/00000658-197703000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Janerich D. T., Glebatis D. M., Dugan J. M. Benign breast disease and oral contraceptive use. JAMA. 1977 May 16;237(20):2199–2201. [PubMed] [Google Scholar]
  12. Kelsey J. L., Lindfors K. K., White C. A case-control study of the epidemiology of benign breast diseases with reference to oral contraceptive use. Int J Epidemiol. 1974 Dec;3(4):333–340. doi: 10.1093/ije/3.4.333. [DOI] [PubMed] [Google Scholar]
  13. Kodlin D., Winger E. E., Morgenstern N. L., Chen U. Chronic mastopathy and breast cancer. A follow-up study. Cancer. 1977 Jun;39(6):2603–2607. doi: 10.1002/1097-0142(197706)39:6<2603::aid-cncr2820390645>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  14. Lees A. W., Burns P. E., Grace M. Oral contraceptives and breast disease in premenopausal Northern Albertan women. Int J Cancer. 1978 Dec;22(6):700–707. doi: 10.1002/ijc.2910220611. [DOI] [PubMed] [Google Scholar]
  15. LiVolsi V. A., Stadel B. V., Kelsey J. L., Holford T. R., White C. Fibrocystic breast disease in oral-contraceptive users. A histopathological evaluation of epithelial atypia. N Engl J Med. 1978 Aug 24;299(8):381–385. doi: 10.1056/NEJM197808242990803. [DOI] [PubMed] [Google Scholar]
  16. Monson R. R., Yen S., MacMahon B. Chronic mastitis and carcinoma of the breast. Lancet. 1976 Jul 31;2(7979):224–226. doi: 10.1016/s0140-6736(76)91026-6. [DOI] [PubMed] [Google Scholar]
  17. Nomura A., Comstock G. W., Tonascia J. A. Epidemiologic characteristics of benign breast disease. Am J Epidemiol. 1977 Jun;105(6):505–512. doi: 10.1093/oxfordjournals.aje.a112413. [DOI] [PubMed] [Google Scholar]
  18. Ory H., Cole P., MacMahon B., Hoover R. Oral contraceptives and reduced risk of benign breast diseases. N Engl J Med. 1976 Feb 19;294(8):419–422. doi: 10.1056/NEJM197602192940804. [DOI] [PubMed] [Google Scholar]
  19. Paffenbarger R. S., Jr, Fasal E., Simmons M. E., Kampert J. B. Cancer risk as related to use of oral contraceptives during fertile years. Cancer. 1977 Apr;39(4 Suppl):1887–1891. doi: 10.1002/1097-0142(197704)39:4+<1887::aid-cncr2820390822>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  20. Ravnihar B., Seigel D. G., Lindtner J. An epidemiologic study of breast cancer and benign breast neoplasias in relation to the oral contraceptive and estrogen use. Eur J Cancer. 1979 Apr;15(4):395–405. doi: 10.1016/0014-2964(79)90074-4. [DOI] [PubMed] [Google Scholar]
  21. Ricciardi I., Ianniruberto A. Tamoxifen-induced regression of benign breast lesions. Obstet Gynecol. 1979 Jul;54(1):80–84. doi: 10.1097/00006250-197907000-00018. [DOI] [PubMed] [Google Scholar]
  22. Ross R. K., Paganini-Hill A., Gerkins V. R., Mack T. M., Pfeffer R., Arthur M., Henderson B. E. A case-control study of menopausal estrogen therapy and breast cancer. JAMA. 1980 Apr 25;243(16):1635–1639. [PubMed] [Google Scholar]
  23. Sartwell P. E., Arthes F. G., Tonascia J. A. Benign and malignant breast tumours: epidemiological similarities. Int J Epidemiol. 1978 Sep;7(3):217–221. doi: 10.1093/ije/7.3.217. [DOI] [PubMed] [Google Scholar]
  24. Sartwell P. E., Arthes F. G., Tonascia J. A. Epidemiology of benign breast lesions: lack of association with oral contraceptive use. N Engl J Med. 1973 Mar 15;288(11):551–554. doi: 10.1056/NEJM197303152881104. [DOI] [PubMed] [Google Scholar]
  25. Vessey M. P., Doll R., Sutton P. M. Oral contraceptives and breast neoplasia: a retrospective study. Br Med J. 1972 Sep 23;3(5829):719–724. doi: 10.1136/bmj.3.5829.719. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Vessey M., Doll R., Peto R., Johnson B., Wiggins P. A long-term follow-up study of women using different methods of contraception--an interim report. J Biosoc Sci. 1976 Oct;8(4):373–427. doi: 10.1017/s0021932000010890. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES