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Features of breast lobule predicted breast cancer risk
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Higher numbers of acini — milk-producing elements within the breast lobule — and larger lobule size were associated with a higher risk for breast cancer.
Researchers enrolled 85 patients with breast cancer and age matched them with 142 participants from the Mayo Benign Breast Disease Cohort. They developed a model to determine risk by examining the number of acini per lobule and lobule area. They determined five-year risk using the Gail model.
Women who developed breast cancer had more acini per lobule than women who did not (24.3 vs. 17.8; P=.0008). The risk for breast cancer increased with greater numbers of acini per lobule (P=.0004). The RR for breast cancer with 41 acini or more was 11.85 (95% CI, 2.92-48.12).
Larger lobule size was associated with an increased risk for breast cancer (P=.045). Women who developed breast cancer had a lobule size of 64,165 mcm2, whereas women without breast cancer had a lobule size of 53,759 mcm2.
Researchers used the concordance statistic to assess the accuracy of risk prediction. The concordance statistic was 0.60 (95% CI, 0.50-0.70) for the Gail model, 0.65 (95% CI, 0.54-0.75) for acinar count and 0.68 (95% CI, 0.58-0.78) for acinar count and lobular area combined.
“These simple physiologic features may offer an alternative strategy for breast cancer risk prediction in women who have had benign biopsies,” the researchers said.
McKian KP. J Clin Oncol. 2009;doi:10.1200/JCO.2008.21.5079.