THE PROGNOSTIC-SIGNIFICANCE OF PREVIOUS BENIGN BREAST DISEASE FOR WOMEN WITH CARCINOMA OF THE BREAST

BACKGROUND: Risk factors for carcinoma of the breast may also have pro gnostic influence. Because benign breast disease is a risk factor for carcinoma of the breast, we compared the outcomes of patients with car cinoma of the breast with a history of benign breast disease to patien ts with carcinoma of the breast without a history of benign breast dis ease. STUDY DESIGN: Patients with benign breast disease and subsequent carcinoma of the breast were matched by age and ethnicity to patients with carcinoma of the breast with no prior history of benign breast d isease. Risk factors, pathologic findings, and disease-free survival r ates were compared. RESULTS: Patients with previous benign breast dise ase had a significantly greater family history of carcinoma of the bre ast (35 percent compared with 22 percent, p=0.015) and used postmenopa usal hormones significantly more frequently (16 percent compared with 5 percent; p<0.001) than women without benign breast disease. In patie nts with benign breast disease, their subsequent carcinomas were small er (T1, 53 percent compared with 43 percent), with significantly fewer nodes involved (1.8 compared with 2.7, p=0.031), and were significant ly more likely to contain an infiltrating lobular component (9 percent compared with 3 percent, p=0.023), Significantly fewer patients with previous benign breast disease had metastatic disease (18 percent comp ared with 31 percent; p=0.001). The ten-year cumulative disease-free s urvival rate for patients with benign breast disease was 68 percent co mpared with 59 percent for women without a history of benign breast di sease. CONCLUSIONS: This study indicates that women with benign breast disease who have carcinoma of the breast develop may have a better ou tcome than women without a history of benign breast disease.