Information from published case-control studies on benign breast disease was pooled using standard statistical methods to obtain single, overall risk estimates. This analysis showed that higher socio-economic status (pooled relative risk, RR = 1.24, 95% confidence interval, CI = 1.13-1.37), later menopause (pooled RR = 1.87, 95%, CI = 1.67-2.11) and late age at first birth (pooled RR = 1.30, 95%, CI = 1.13-1.50) were associated with an increased risk of benign breast disease, whereas an apparent protection was given by greater body mass index (pooled RR = 0.58, 95%, CI = 0.50-0.67) and the use of oral contraceptives (pooled RR = 0.75, 95%, CI = 0.67-0.83). The role of these factors did not appear to be materially different in the various histopathologic categories considered, although available information allowed only a general distinction between breast dysplasia (fibrocystic disease) and benign tumors, chiefly fibroadenoma. In conclusion, the general evidence from published studies indicates that benign breast lumps appear to share a number of important risk factors with breast cancer.
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References
1.
KelseyJ.L.: A review of the epidemiology of human breast cancer.Epidemiol. Rev., 1: 74–109, 1979.
2.
SoiniI., AineR., LauslahtiK., HakamaM.: Independent risk factors of benign and malignant breast lesions.Am. J. Epidemiol., 114: 507–514, 1981.
3.
VesseyM.P., DollR., SuttonP.M.: Oral contraceptives and breast neoplasia: A retrospective study.Br. Med. J., 3: 719–724, 1972.
4.
SartwellP.E., ArthesF.G., TonasciaJ.A.: Epidemiology of benign breast lesions: Lack of association with oral contraceptive use.N. Engl. J. Med., 288: 551–554, 1973.
5.
SartwellP.E., ArthesF.G., TonasciaJ.A.: Benign and malignant breast tumours: Epidemiological similarities.Int. J. Epidemiol., 7: 217–221, 1978.
6.
The Boston Collaborative Drug Surveillance Program:Oral contraceptives and venous thromboembolic disease, surgically confirmed gallbladder disease, and breast tumours.Lancet, 1: 1399–1404, 1973.
7.
KelseyJ.L., LindforsK.K., WhiteC.: A case-control study of the epidemiology of benign breast diseases with reference to oral contraceptive use.Int. J. Epidemiol., 3: 333–340, 1974.
8.
KelseyJ.L., HolfordT.R., WhiteC., MayerE.S., KiltyS.E., AchesonR.M.: Oral contraceptives and breast disease. An epidemiological study.Am. J. Epidemiol., 107: 236–244, 1978.
9.
FasalE., PaffenbargerR.S.Jr.: Oral contraceptives as related to cancer and benign lesions of the breast.J. Natl. Cancer Inst., 55: 767–773, 1975.
10.
NomuraA., ComstockG.W., TonasciaJ.A.: Epidemiologic characteristics of benign breast disease.Am. J. Epidemiol., 105: 505–512, 1977.
11.
JanerichD.T., GlebatisD.M., DuganJ.M.: Benign breast disease and oral contraceptive use.JAMA, 237: 2199–2201, 1977.
12.
ColeP., ElwoodJ.M., KaplanS.D.: Incidence rates and risk factors of benign breast neoplasms.Am. J. Epidemiol., 108: 112–120, 1978.
13.
RavniharB., SeigelD.G., LindtnerJ.: An epidemiologic study of breast cancer and benign breast neoplasias in relation to the oral contraceptive and estrogen use.Eur. J. Cancer, 15: 395–405, 1979.
14.
BrintonL.A., VesseyM.P., FlavelR., YeatesD.: Risk factors for benign breast disease.Am. J. Epidemiol., 113: 203–214, 1981.
15.
DuffyS.W., RobertsM.M., EltonR.A.: Risk factors relevant to cystic breast disease: A case-control study.J. Epidemiol. Commun. Health, 37: 271–273, 1983.
16.
ParazziniF., La VecchiaC., FranceschiS., DecarliA., GallusG., RegalloM., LiberatiA., TognoniG.: Risk factors for pathologically confirmed benign breast diseases.Am. J. Epidemiol., 120: 115–122, 1984.
17.
MantelN., HaenszelW.: Statistical aspects of the analysis of data from retrospective studies of disease.J. Natl. Cancer Inst., 22: 719–748, 1959.
18.
DeWaardF.: Breast cancer incidence and nutritional status with particular reference to body weight and height.Cancer Res., 35: 3351–3356, 1975.
19.
LiVolsiV.A., StadelB.V., KelseyJ.L., HolfordT.R., WhiteC.: Fibrocystic breast disease in oral-contraceptive users. A histopathological evaluation of epithelial atypia.N. Engl. J. Med., 299: 381–385, 1978.
20.
PastidesH., KelseyJ.L., LiVolsiV.A., HolfordT.R., FischerD.B., GoldenbergI.S.: Oral contraceptive use and fibrocystic breast disease with special reference to its histopathology.J. Natl. Cancer Inst., 71: 5–9, 1983.
21.
MirraA.P., ColeP., MacMahonB.: Breast cancer in an area of high parity.Sao Paulo, Brazil, Cancer Res., 31: 77–83, 1971.
22.
DeWaardF., HalewijnE.A.B.: A prospective study in general practice on breast cancer risk in postmenopausal women.Int. J. Cancer, 14: 153–160, 1974.
23.
HelmrichS.P., ShapiroS., RosenbergL., KaufmanD.W., SloneD., BainC., MiettinenO.S., StolleyP.D., RosenheimN.B., KnappR.C., LeavittT.Jr., SchottenfeldD., EngleR.L.Jr., LevyM.: Risk factors for breast cancer.Am. J. Epidemiol., 117: 35–45, 1983.
24.
KelseyJ.L.: A review of the epidemiology of human breast cancer.Epidemiol. Rev., 1: 74–109, 1979.
25.
TalaminiR., La VecchiaC., DecarliA., FranceschiF., GrattoniE., GrigolettoE., LiberatiA., TognoniG.: Social factors, diet and breast cancer in a northern Italian population.Br. J. Cancer, 49: 723–729, 1984.
26.
BrissonJ., MorrisonA.S., KopansD.B.: Height and weight mammographic features of breast tissue, and breast cancer risk.Am. J. Epidemiol., 119: 371–381, 1984.
27.
SiiteriP.K.: Steroid hormones and endometrial cancer.Cancer Res., 38: 4360–4366, 1978.
28.
ChoiN.W., HoweG.R., MillerA.B., MatthewsV., MorganR.W., MunanL., BurchJ.D., FeatherJ., JainM., KellyA.: An epidemiologic study of breast cancer.Am. J. Epidemiol., 107: 510–521, 1978.
29.
PaffenbargerR.S.Jr., KampertJ.B., ChangH.G.: Characteristics that predict risk of breast cancer before and after the menopause.Am. J. Epidemiol., 112: 258–268, 1980.
30.
LeesA.W., BurnsP.E., GraceM.: Oral contraceptives and breast disease in premenopausal northern Albertan women.Int. J. Cancer, 22: 700–707, 1978.
31.
PikeM.C., HendersonB.E., CasagrandeJ.T., RosarioI., GrayG.E.: Oral contraceptive use and early abortion as risk factors for breast cancer in young women.Br. J. Cancer, 43: 72–76, 1981.
32.
BrintonL.A., HooverR., SzkloM., FraumeniJ.F.Jr.: Oral contraceptives and breast cancer.Int. J. Epidemiol., 11: 316–322, 1982.
33.
JanerichD.T., PolednakA.P., GlebatisD.M., LawrenceC.E.: Breast cancer and oral contraceptive use: A case-control study.J. Chron. Dis., 36: 639–646, 1983.
34.
DaviesH.H., SimonsM., DaviesJ.B.: Cystic disease of the breast: Relationship to carcinoma.Cancer, 17: 957–978, 1964.
35.
VeronesiU., PizzocaroG.: Breast cancer on women subsequent to cystic disease of the breast.Surg. Gynecol. Obstet., 126: 529–532, 1968.
36.
MonsonR.R., YenS., MacMahonB.: Chronic mastitis and carcinoma of the breast.Lancet, 2: 224–226, 1976.
37.
KodlinD., WingerE.E., MorgensternN.L., ChenU.: Chronic mastopathy and breast cancer.Cancer, 39: 2603–2607, 1977.
38.
PageD.L., Vander ZwaagR., RogersN.W., WilliamsL.T., WalkerW.E., HartmannW.H.: Relation between component parts of fibrocystic disease complex and breast cancer.J. Natl. Cancer Inst., 61: 1055–1064, 1978.
39.
HutchinsonB., ThomasD.B., HamlinW.B., RothG.J., PetersonA.V., WilliamsB.: Risk of breast cancer in women with benign breast disease.J. Natl. Cancer Inst., 65: 13–20, 1980.
40.
CoombsL.J., LilienfeldA.M.: A prospective study of the relationship between benign breast diseases and breast carcinoma.Prev. Med., 8: 40–52, 1979.
41.
HaagensonC.D., BodianC., HaagersonD.E.: Breast Carcinoma Risik and Detection, pp. 70–74, W.B. Saunders Co., Philadelphia, 1981.
42.
DuffyS.W., RobertsM.M., EltonR.A.: Risk factors for breast cancer: Relevance to screening.J. Epidemiol. Commun. Health, 37: 127–131, 1983.
43.
ShapiroS., StraxP., VenetL., FinkR.: The search for risk factors in breast cancer.Am. J. Public Health, 58: 820–835, 1968.
44.
LubinJ.H., BurnsP.E., BlotW.J., LeesA.W., MayC., MorrisL.E., FraumeniJ.F.: Risk factors for breast cancer in women in Northern, Alberta, Canada, as related to age at diagnosis.J. Natl. Cancer Inst., 68: 211–217, 1982.
45.
VesseyM.P., DollR., JonesK., McPhersonK., YatesD.: An epidemiological study of oral contraceptives and breast cancer.Br. Med. J., 1: 1755–1758, 1979.
46.
WynderE.L., MacCormackF.A., StellmanS.D.: The epidemiology of breast cancer in 785 US Caucasian women.Cancer, 41: 2341–2354, 1978.
47.
BrintonL.A., WilliamsR.R., HooverR.N., StegensN.L., FeinleibM., FraumeniJ.F.: Breast cancer risk factors among screening programme participants.J. Natl. Cancer Inst., 62: 37–44, 1979.
48.
RobertsM.M., JonesV., EltonR.A., ForttR.W., WilliamsS., GravelleI.H.: Risk of breast cancer in women with history of benign disease of the breast.Br. Med. J., 288: 275–278, 1984.
