CLINICAL DETERMINANTS OF MAMMOGRAPHIC DYSPLASIA PATTERNS

The association between the clinical manifestations of benign breast d isease (BBD) and mammographic patterns was investigated among 1394 wom en (923 pre-menopausal and 471 postmenopausal) participating to the Ca nadian National Breast Screening Study in Vancouver, who completed a q uestionnaire designed to collect detailed information on the symptoms and signs of BED, hormonal, reproductive and dietary factors. Mastalgi a was present in 637 (46%) women and was cyclical in 505 (79%). Breast swelling was noted in 331 women (23%) and mammary dysplasia involving 50% or more of the breast parenchyma in 733 (43%). Mastalgia was high ly associated with breast swelling (odds ratios [OR] = 29.9, 95% confi dence interval [CI] = 21.3-41.8), particularly when cyclical and chara cterized by tenderness with pain (OR = 58.4, 95% CI = 39.1-87.0). The relative risk for mammary dysplasia involving 50% or over of the breas t parenchyma was significant in premenopausal women having breast swel ling(OR = 2.96, 95% CI = 1.81-4.83), being highest in women with cycli cal mastalgia associated with tenderness and pain (OR = 3.43, 95% CI = 1.49-7.92); similar associations were noted in post-menopausal women. This study indicates that mastalgia is strongly related to breast swe lling, especially when tenderness is associated with pain. Furthermore , mastalgia associated with breast swelling is highly related to the p resence of mammary dysplasia involving 50% or more of the breast paren chyma in both pre- and post-menopausal women, suggesting that cyclical tenderness and breast swelling may carry an increased breast cancer r isk.