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The Cancer Committee of the College of American Pathologists has prepared an update of the consensus statement on premalignant breast lesions and breast cancer risk that was originally published in the Archives of Pathology & Laboratory Medicine in 1986. The objective of this publication is to better define the relative breast cancer risk associated with specific histologic abnormalities by incorporating data derived from recent case-control studies. Explanatory notes are used to document and explain specific risk classifications. In addition to refining the degree of risk associated with individual lesions, such as fibroadenoma and atypical hyperplasia, this update includes a discussion of age-specific breast cancer risk and provides examples that can be used when counseling patients.
(Arch Pathol Lab Med. 1998;122:1053-1055)
In October 1985, a meeting was convened by the Cancer Committee of the College of American Pathologists to document the diagnostic terminology and clinical significance of histologic breast changes generally grouped together under the term fibrocystic disease. The meeting resulted in publication of a consensus statement1 that categorized the lesions according to their relative risk for subsequent breast cancer, provided definitions for some of the lesions, and included a recommendation that individual histologic findings be specifically reported under the rubric of fibrocystic changes rather than fibrocystic disease.
Several large case-control studies have since been published clarifying the association between benign histologic breast abnormalities and breast cancer risk.2-7 While generally supporting the risk categorization described in the original statement,1 these studies have provided supplementary information. This report represents an update of the original consensus statement incorporating this newer information (Table 1).
As in the earlier document, the risks listed for each category do not signify an absolute risk or probability that an individual will develop breast cancer, but represent relative risks, which are comparisons with age-matched women in the general population. A relative risk of 2.0 signifies that a patient has twice the chance of developing invasive breast cancer over a given time period as women of similar age without these histologic changes. For example, the absolute risk that a 40-year-old woman will develop breast cancer in the next 10 years is one in 67 (Table 2). If she has a relative risk of 2.0, her chance of developing breast cancer in the next year...