BREAST CANCER RISK ASSESSMENT IN BENIGN BREAST DISEASE

该提案利用了马约诊所的独特资源， 罗切斯特流行病学项目（REPP）进行了一项 评估乳腺癌风险的回顾性发病率队列研究 在患有良性乳腺疾病的女性中。 通过整合 马约诊所的组织病理学评价能力和 根据REPP提供的基于人群的流行病学数据， 研究将对乳腺癌的风险进行详细评估， 与特定组织学定义相关的癌症 良性乳腺增生病的亚类。 研究 病理学家将与佩奇博士合作，以确保 将Page-Dupont标准应用于乳腺组织病理学检查， 公里. 来自估计的9,000名妇女的乳房组织， 奥姆斯特德县社区和马约诊所从1967年1月1日- 1/1/83将根据这些标准进行组织病理学评价， 将对该回顾性发病率队列进行随访， 乳腺癌发病率为1/1/88。 使用乳腺癌病例 以及来自该队列的匹配对照组， 这些病人的医疗记录。 此外，DNA流 将对良性肿瘤进行细胞计数和免疫组化。 来自病例和对照的乳腺疾病组织。 将合并的 临床、流行病学、流式细胞术和组织病理学数据 将用于评估这些因素之间的相互作用， 乳腺癌风险。 以前的REPP研究涉及 乳腺良性病变与继发乳腺癌的关系 癌症肯定了这个数据源识别癌症的能力。 相关研究人群。 持续参与DES- 乳腺癌研究证实了确定 适当的临床和流行病学参数，并提供 近100%随访乳腺癌发生率至1/1/88， 这个（9，000）良性乳腺疾病发病率队列的成员。 更 在这个队列中预计有300多例乳腺癌病例 其应提供足够的功率以在临床上检测， 重要的统计关系。 比较 奥姆斯特德县队列和非奥姆斯特德县队列之间 马约诊所转诊队列将提供一个独特的机会， 确定转诊偏倚对以下疾病流行病学的影响： 良性乳腺疾病。 因此，本研究将评估 预测有效性的页面杜邦标准，并确定是否 其他临床、流行病学、流式细胞术或 组织病理学因素提高了风险评估的精确度。

This proposal utilizes the unique resources of Mayo Clinic and the Rochester Epidemiology Program Project (REPP) to conduct a retrospective incidence cohort study to assess breast cancer risk among women with benign breast disease. By integrating the histopathologic evaluation capabilities of Mayo Clinic and the population-based epidemiologic data provided by the REPP, this research will provide a detailed assessment of the risk of breast cancer associated with specific histologically defined subcategories of proliferative benign breast disease. The study pathologist will collaborate with Dr. Page to ensure that the Page-Dupont criteria are applied to the breast tissue pathologic slides. Breast tissue from an estimated (9,000) women in the Olmsted County community and at Mayo Clinic from 1/1/67- 1/1/83 will be evaluated histopathologically with these criteria, and this retrospective incidence cohort will be followed for occurrence of breast cancer to 1/1/88. Using breast cancer cases and a matched control group from this cohort, a nested biopsy from medical records of these patients. In addition, DNA flow cytometry and immunohistochemistry will be conducted on benign breast disease tissue from cases and controls. The combined clinical, epidemiologic, flow cytometric, and histopathologic data will be used to evaluate the interaction between these factors and breast cancer risk. Previous REPP research concerned with the relationship between benign breast lesions and subsequent breast cancer affirms the ability of this data source to identify the relevant study population. Ongoing participation in the DES- breast cancer studies verifies the ability to determine the appropriate clinical and epidemiologic parameters and to provide nearly 100% follow-up for breast cancer occurrence to 1/1/88 in this (9,000) member benign breast disease incidence cohort. More than 300 cases of breast cancer are anticipated in this cohort which should provide adequate power to detect clinically and statistically important relationships of interest. Comparisons between the Olmsted County cohort and the non-Olmsted County Mayo Clinic referral cohort will provide a unique opportunity to determine the influence of referral bias on the epidemiology of benign breast disease. This study will, therefore, assess the predictive validity of the Page-Dupont criteria and determine if additional clinical, epidemiologic, flow cytometric, or histopathologic factors improve the precision of risk assessment.