Benign Breast Disease in African-American Women
B Sharafeldeen, K Hayek, M Frost, L Hartmann, D Visscher, H Nassar. Wayne State University, Detroit; Mayo Clinic, Rochester; University of Michigan, Ann Arbor; Johns Hopkins, Baltimore
Background: Women with benign breast disease (BBD) represent a large and clinically important population. Specific histologic findings in BBD have been shown to be strong indicators of later risk of breast cancer. The major studies of BBD performed to date have been based primarily in Caucasian-American (CA) women. Thus, the prevalence and distribution pattern of BBD in African American (AA) women is not well known.
Design: We reviewed archival H and E stained sections of breast needle core and excisional biopsies performed on all AA women in the years 1998 to 2000 at our institution and diagnosed with BBD. BBD was classified, by one pathologist, as nonproliferative (NP), proliferative disease without atypia (PDWA) or atypical hyperplasia including ductal and lobular types (AH), using standard microscopic criteria. We also examined the status of lobular involution in the same biospies and classified it as none or absent (<1%), partial (1-75%), or complete (75%). We compared lobular involution in our population to that of a cohort of CA women with a diagnosis of BBD within the same age category (<45y; 45-55y and >55y).
Results: We identified 520 AA patients with a diagnosis of BBD on breast biopsy. The mean age at diagnosis was 46.4 years (14.7 y). Seventy-five percent were diagnosed with NP, 22% with PDWA, and 3% with AH. Lobular involution increased with age. In women older than 55 years however, the increase in lobular involution appeared to be slower in AA than in CA women (CA had 2.7% none vs. 44% complete and AA had 19% none vs. 31% complete; p<0.001). There was no difference between AA and CA women younger than 55 years in regard to the presence of lobular involution. Lobular involution was similar throughout the different BBD categories in the AA population.
Conclusions: In our series of AA women with BBD, the distribution of BBD appears to be similar to other series (including mainly CA women). Our data on lobular involution may indicate that AA undergo lobular involution at a different rate than CA women.
Monday, March 9, 2009 8:15 AM
Platform Session: Section B, Monday Morning