Clinical Characteristics of Breast Cancers in African-American Women with Benign Breast Disease: A Comparison to the Surveillance, Epidemiology, and End Results Program

Benign breast disease (BBD) is a very common condition, diagnosed in approximately half of all American women at some point in their lives (1). Along with age, reproductive factors and family history, it is well established that BBD raises long-term breast cancer risk (2–7). Different types of BBD have been associated with differentially elevated risk: nonproliferative lesions confer a relatively low level of additional risk, while proliferative lesions with atypia confer a much greater risk (7,8). However, although lesions differentially elevate breast cancer risk, little is known about whether different lesions predict the development of specific types of breast cancer (9). There are known racial disparities between African-American and white women in the epidemiology of breast cancer. For example, African-American women develop breast cancer at a younger age and present with more advanced tumors (10–12). Despite these differences, recent research has suggested that the association between BBD and breast cancer first described in white women also applies to African-American women (8,13). BBD and breast cancer may even be more strongly associated in African-American women than they are in white women (14). Therefore, it is important to better characterize the association between BBD and breast cancer in African-American women. Although it is well known that BBD elevates risk of breast cancer, no studies have compared the breast cancer characteristics of women with a history of BBD to the breast cancer characteristics of the general population. Such a comparison is of interest because women with BBD are at elevated risk for breast cancer, so it is important to determine whether their tumors are clinically different from those of the general population. It is possible that because women who have been diagnosed with BBD have established access to medical care and some awareness of breast health, their cancers will be diagnosed earlier. In this study, we will compare the characteristics of breast cancers in women with a history of BBD to the characteristics of breast cancers in a large population-based sample of women.