THE IMPORTANCE OF PROLIFERATIVE LESIONS IN BENIGN BREAST DISEASE AND THEIR RISKS OF CANCER

Abstract

Physiologic changes imitating benign breast lesions might cause unnecessary breast tissue excision and some controversies on the relationship between breast cancer and benign lesions.

Proliferative level of benign breast lesions may eliminate the group of physiologic changes (nonproliferative lesions) and measure the cancer risk of true benign pathologies.

Atypical hyperplasia has a high rate of relative risk (3.0-4.3) versus epithelial hyperplasia (1.3-1.8) according to Dupont-Page criteria. But the study excluding the criteria of ductal carcinoma insitu for the diagnosis of atypical hyperplasia (Bodian-Haagensen criteria) has failed to show this difference on the risk (2.1 for epithelial and 2.3 for atypical hyperplasia).

It seems that the criteria of atypical hyperplasia have the greatest effect on the relative cancer risk. Prospective studies correlating the criteria of atypical hyperplasia should be performed and new markers (like c-erb, p53, angiogenesis factor) should be investigated to determine a borderline between atypia and insitu cancer of breast.