Women with dense breasts and no lobular involution were at a higher risk for developing breast cancer than those with non-dense breasts and complete involution.

Apart from age, family history, and age at menarche, two additional factors associated with breast cancer risk include mammographic breast density and extent of lobular involution. Lobular involution is the physiological atrophy of the breast epithelium and is known to increase with increasing age.

To determine whether these two factors are independently associated with breast cancer risk, KarthikGhosh, MD, of the Mayo Clinic, and colleagues investigated the factors’ association with breast cancer risk in a cohort of 2666 women with benign breast disease, followed for a mean of 13.3 years; 172 ( 6.5% ) women subsequently developed breast cancer.

The researchers took their cohort from the larger Mayo Breast Disease cohort, which included 9376 women between the ages of 18 and 85, with no history of breast cancer, who were diagnosed with benign breast disease between 1967 and the end of 1991. The researchers found that breast density and extent of lobular involution were independent risk factors for breast cancer, and that combined, they pose an even greater risk.

In an accompanying editorial, Gretchen L. Gierach, of the National Cancer Institute, and colleagues, have described lobular involution and mammographic breast density as factors that hold promise for improving risk prediction, particularly because they reflect the cumulative interplay of numerous genetic and environmental breast cancer risk factors over time.
Future studies should include larger numbers of patients from diverse racial and ethnic backgrounds and aim to understand the relationship between involution and epidemiological risk factors such as body mass index. Furthermore, since neither lobular involution nor mammographic breast density are static processes, evaluating changes over time may improve their predictive value.

Source: Journal of National Cancer Institute, 2010

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