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BENIGN BREAST LESIONS

There is a good chance that many of you women reading this will at some point in your lifetime have to go for a breast biopsy; and that biopsy won’t turn out to be a cancer.

But does that mean you’re completely out of the woods? The answer is no, but it also doesn’t mean worry.

Most women who go in for a biopsy for breast cancer get a negative result. But does that mean you’re completely out of the woods? The answer is no, but it also doesn’t mean worry.

This latest research study shows the degree of risk associated with a benign breast lesion depends upon what the tissue looked like under the microscope, the family history of the woman, and the age at which the biopsy was taken.

At a time when more and more women are being diligent about getting annual mammograms, there are in turn, more and more detected abnormal spots .which end up getting biopsied to see if, indeed, they are cancer.

Charlotte Wile is a good example. “They did a biopsy, it was benign, that was it for a while, and then I had another mammogram that showed an assorted variety of microscopic calcifications and they weren’t certain. So I had another biopsy and that was also benign,” says Charlotte who ended up not having breast cancer. But like many women who get biopsies, it doesn’t mean their risk is zero. It depends.

A study in the New England Journal of Medicine highlights how much of a risk benign--or non-cancer--breast lesions play in terms of future breast cancer. Overall the risk relative to those without breast lesions is 1.56…or 56% more. But the risk is greatest in those with lesions that look atypical under the microscope, compared to those that look like completely normal tissue.

And, a family history of breast cancer plays a role; for example, an atypical lesion poses a three times greater risk in someone with no family history, but a four times greater risk in someone with a family history.

“My mother was diagnosed with breast cancer when she was 57 and had a radical mastectomy and in ‘89 my sister was diagnosed with breast cancer and she had a lumpectomy,” says Charlotte.

Dr. Melita Charles, a breast surgeon at Long Island College Hospital, New York, says, “Most women will have someone in their family who has a breast cancer the importance is really in women with first degree relatives meaning mother, mother’s sister, or her own sister.” The risk is about the same for breast cancer in either breast; it’s likely an overall risk.

Age is also a factor. The risk of breast cancer was seven times greater in those dianagosed with an abnormal looking but benign lesion before the age of 45. The risk eventually starts to wane, but only 25 years after the biopsy was first taken.

How one spins the numbers is key; it’s important to realize that a benign breast lesion only increases the risk of breast cancer, not death, and that treatment for breast cancer has improved markedly.

“If a woman has increased risk compared to the general population then she should just continue with her annual screening mammograms follow ups to her family doctor or gynecologist or breast surgeon for annual examinations and self examinations as well,” says Dr. Charles.

Still, it’s important for women with even the most benign breast lesions--and in fact, all women over 40--to get regular mammograms.

“A woman who has no family members with breast cancer still has a risk of breast cancer because all you need is to have is to be a female and have breasts and there are plenty of women who think they don’t have a risk of breast cancer because no one in my family has had breast cancer,” Dr. Charles states.

For more information on breast cancer risk and to calculate risk, go to:

http://bcra.nci.nih.gov/brc/

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