FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 340:430-436 February 11, 1999 Number 6 Next

	Full Text PDF Letters Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Radial scars are benign breast lesions of uncertain clinical significance. In particular, it is not known whether these lesions alter the risk of breast cancer in women with benign breast disease. We conducted a case–control study of women who had benign breast lesions with or without radial scars.

Methods We reviewed benign breast-biopsy specimens from 1396 women enrolled in the Nurses' Health Study, including 255 women in whom breast cancer subsequently developed and 1141 women without subsequent breast cancer (controls). The controls were matched to the women with subsequent breast cancer according to age and the year when the benign lesion was identified. The median follow-up after biopsy of the benign lesions was 12 years.

Results Radial scars were identified in biopsy specimens from 99 women (7.1 percent). Most biopsy specimens with radial scars had only one radial scar (60.6 percent), and they tended to be incidental microscopical findings (median size, 4.0 mm). The women with radial scars had a risk of breast cancer that was almost twice the risk of the women without scars, regardless of the histologic type of benign breast disease (relative risk, 1.8; 95 percent confidence interval, 1.1 to 2.9). Among women who had proliferative disease without atypia as compared with women who had nonproliferative disease, the relative risk of breast cancer was 3.0 (95 percent confidence interval, 1.7 to 5.5) for those with radial scars and 1.5 (95 percent confidence interval, 1.1 to 2.1) for those without radial scars. Among women with atypical hyperplasia as compared with women with nonproliferative disease, the relative risk of breast cancer was 5.8 (95 percent confidence interval, 2.7 to 12.7) for those with radial scars and 3.8 (95 percent confidence interval, 2.4 to 5.9) for those without radial scars.

Conclusions Radial scars are an independent histologic risk factor for breast cancer.

Source Information

From the Department of Pathology, Beth Israel Deaconess Medical Center (T.W.J., J.L.C., S.J.S.); Harvard Medical School (T.W.J., C.B., G.C., J.L.C., S.J.S.); and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital (C.B., G.C.) — all in Boston.

Address reprint requests to Dr. Schnitt at the Department of Pathology, Beth Israel Deaconess Medical Center, East Campus, 330 Brookline Ave., Boston, MA 02215.

Full Text of this Article

Related Letters:

Radial Scars and Breast Cancer
Mokbel K., Price R.K., Carpenter R., Jacobs T. W., Connolly J. L., Schnitt S. J.
Extract | Full Text  
N Engl J Med 1999; 341:210, Jul 15, 1999. Correspondence

Assessment of Splenic Function in Familial Asplenia
Feder H. M., Pearson H. A.
Extract | Full Text  
N Engl J Med 1999; 341:210-212, Jul 15, 1999. Correspondence

This article has been cited by other articles:

• Colditz, G. A., Winn, D. M. (2008). Criteria for the Evaluation of Large Cohort Studies: An Application to the Nurses' Health Study. JNCI J Natl Cancer Inst 100: 918-925 [Abstract] [Full Text]  
• Worsham, M. J., Raju, U., Lu, M., Kapke, A., Cheng, J., Wolman, S. R. (2007). Multiplicity of Benign Breast Lesions Is a Risk Factor for Progression to Breast Cancer. Clin. Cancer Res. 13: 5474-5479 [Abstract] [Full Text]  
• Ashbeck, E. L., Rosenberg, R. D., Stauber, P. M., Key, C. R. (2007). Benign Breast Biopsy Diagnosis and Subsequent Risk of Breast Cancer. Cancer Epidemiol. Biomarkers Prev. 16: 467-472 [Abstract] [Full Text]  
• Guray, M., Sahin, A. A. (2006). Benign breast diseases: classification, diagnosis, and management.. The Oncologist 11: 435-449 [Abstract] [Full Text]  
• Burnside, E. S., Rubin, D. L., Shachter, R. D., Sohlich, R. E., Sickles, E. A. (2004). A Probabilistic Expert System That Provides Automated Mammographic-Histologic Correlation: Initial Experience. Am. J. Roentgenol. 182: 481-488 [Abstract] [Full Text]  
• Kennedy, M, Masterson, A V, Kerin, M, Flanagan, F (2003). Pathology and clinical relevance of radial scars: a review. J. Clin. Pathol. 56: 721-724 [Abstract] [Full Text]  
• Morris, E. A., Liberman, L., Ballon, D. J., Robson, M., Abramson, A. F., Heerdt, A., Dershaw, D. D. (2003). MRI of Occult Breast Carcinoma in a High-Risk Population. Am. J. Roentgenol. 181: 619-626 [Abstract] [Full Text]  
• Gombos, E. C., Poppiti, R. J. Jr., Brenner, R. J. (2003). Percutaneous Core Needle Biopsy of Radial Scars of the Breast. Am. J. Roentgenol. 181: 275-275 [Full Text]  
• Chauhan, H, Abraham, A, Phillips, J R A, Pringle, J H, Walker, R A, Jones, J L (2003). There is more than one kind of myofibroblast: analysis of CD34 expression in benign, in situ, and invasive breast lesions. J. Clin. Pathol. 56: 271-276 [Abstract] [Full Text]  
• Byrne, C., Webb, P. M., Jacobs, T. W., Peiro, G., Schnitt, S. J., Connolly, J. L., Willett, W. C., Colditz, G. A. (2002). Alcohol Consumption and Incidence of Benign Breast Disease. Cancer Epidemiol. Biomarkers Prev. 11: 1369-1374 [Abstract] [Full Text]  
• Brenner, R. J., Jackman, R. J., Parker, S. H., Evans, W. P. III, Philpotts, L., Deutch, B. M., Lechner, M. C., Lehrer, D., Sylvan, P., Hunt, R., Adler, S. J., Forcier, N. (2002). Percutaneous Core Needle Biopsy of Radial Scars of the Breast: When Is Excision Necessary?. Am. J. Roentgenol. 179: 1179-1184 [Abstract] [Full Text]  
• Aharinejad, S., Abraham, D., Paulus, P., Abri, H., Hofmann, M., Grossschmidt, K., Schafer, R., Stanley, E. R., Hofbauer, R. (2002). Colony-stimulating Factor-1 Antisense Treatment Suppresses Growth of Human Tumor Xenografts in Mice. Cancer Res. 62: 5317-5324 [Abstract] [Full Text]  
• Heikinheimo, K., Jee, K.J., Niini, T., Aalto, Y., Happonen, R.-P., Leivo, I., Knuutila, S. (2002). Gene Expression Profiling of Ameloblastoma and Human Tooth Germ by Means of a cDNA Microarray. JDR 81: 525-530 [Abstract] [Full Text]  
• Zhu, Y., Spitz, M. R., Lei, L., Mills, G. B., Wu, X. (2001). A Single Nucleotide Polymorphism in the Matrix Metalloproteinase-1 Promoter Enhances Lung Cancer Susceptibility. Cancer Res. 61: 7825-7829 [Abstract] [Full Text]  
• Rockhill, B., Spiegelman, D., Byrne, C., Hunter, D. J., Colditz, G. A. (2001). Validation of the Gail et al. Model of Breast Cancer Risk Prediction and Implications for Chemoprevention. JNCI J Natl Cancer Inst 93: 358-366 [Abstract] [Full Text]  
• Ha, H.-Y., Moon, H.-B., Nam, M.-S., Lee, J.-W., Ryoo, Z.-Y., Lee, T.-H., Lee, K.-K., So, B.-J., Sato, H., Seiki, M., Yu, D.-Y. (2001). Overexpression of Membrane-type Matrix Metalloproteinase-1 Gene Induces Mammary Gland Abnormalities and Adenocarcinoma in Transgenic Mice. Cancer Res. 61: 984-990 [Abstract] [Full Text]  
• Ashburn, T. T., Wilson, S. K., Eisenstein, B. I. (2000). Human Tissue Research in the Genomic Era of Medicine: Balancing Individual and Societal Interests. Arch Intern Med 160: 3377-3384 [Abstract] [Full Text]  
• Shoker, B S, Jarvis, C, Clarke, R B, Anderson, E, Munro, C, Davies, M P A, Sibson, D R, Sloane, J P (2000). Abnormal regulation of the oestrogen receptor in benign breast lesions. J. Clin. Pathol. 53: 778-783 [Abstract] [Full Text]  
• Philpotts, L. E., Shaheen, N. A., Jain, K. S., Carter, D., Lee, C. H. (2000). Uncommon High-Risk Lesions of the Breast Diagnosed at Stereotactic Core-Needle Biopsy: Clinical Importance. Radiology 216: 831-837 [Abstract] [Full Text]  
• Bazzano, L. A., Del Priore, G., Lee, M.-J., Glaser, A. N., Harvey, J. A., Newschaffer, C. J., Helzlsouer, K. J., Roca, C. A., Schmidt, P. J., Daly, R. C., Rubinow, D. R., Schairer, C., Lubin, J., Troisi, R., Sturgeon, S., Brinton, L., Hoover, R. (2000). Estrogen-Progestin Replacement and Risk of Breast Cancer. JAMA 284: 691-694 [Full Text]  
• Cohen, M. A., Sferlazza, S. J. (2000). Role of Sonography in Evaluation of Radial Scars of the Breast. Am. J. Roentgenol. 174: 1075-1078 [Abstract] [Full Text]  
• Garber, J. (1999). A 40-Year-Old Woman With a Strong Family History of Breast Cancer. JAMA 282: 1953-1960 [Full Text]  
• Greenberg, J. S., Smetherman, D. H. (1999). Invited Commentary. RadioGraphics 19: 36-37 [Full Text]  
• Mokbel, K., Price, R.K., Carpenter, R., Jacobs, T. W., Connolly, J. L., Schnitt, S. J. (1999). Radial Scars and Breast Cancer. NEJM 341: 210-210 [Full Text]