Lancet 1999 May 22;353(9166):1742-5
Risk of breast cancer in women with palpable breast cysts:
a prospective study. Edinburgh Breast Group.
Dixon JM, McDonald C, Elton RA, Miller WR Edinburgh
Breast Unit, Western General Hospital, UK.
BACKGROUND: 7% of women in the western world develop
palpable breast cysts. Studies of the relation between cysts and breast cancer have conflicting
results. There are two clearly defined types of cyst. We investigated whether one cyst type is associated
with a higher rate of breast-cancer development than the other. METHODS: We studied 1374 women with
palpable breast cysts presenting between 1981 and 1987, who had cysts aspirated between 1981 and 1989.
Cysts were classified as type I if the sodium/potassium (Na+/K+) ratio in the cyst fluid was less
than 3, or type II if the Na+/K+ ratio was 3 or more. Data on incidence of breast cancer were available
until January, 1995, and we compared them with the expected numbers of cancers calculated from age-specific
breast-cancer incidence in Scotland in 1988. FINDINGS: 65 cancers developed during follow-up. The
overall standardised incidence rate of breast cancer in patients with palpable cysts was 2.81 (95%
CI 2.17-3.59). The relative incidence rate was increased for all cyst types. The standardised incidence
rate of developing breast cancer among women younger than 45 years was highest at 5.94 (2.97-10.63),
with a significant trend for decreasing relative incidence rate with age (p<0.05). Women older than
54 years had a standardised incidence rate of 1.73 (0.86-3.10). The standardised incidence rate
of breast cancer was highest in the first year after aspiration (7.02 [3.73-12.00]) but the risk was
still raised after 5 years (2.68 [1.84-3.76]). INTERPRETATION: Women with breast cysts are at an increased
risk of breast cancer, especially at younger ages. The type of cyst did not alter the associated relative
incidence rate of breast-cancer development.
PMID: 10347986, UI: 99275742
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