Prior Biopsy -Why Does This Increase Risk for Breast Cancer

Anonymous

Prior Biopsy -Why Does This Increase Risk for Breast Cancer

Anonymous

Why does having a prior breast biopsy which is negative increase our chances of having breast cancer?  Does anyone understand this risk factor?

roseg

I don't believe the biopsy itself increases risk.

They're just using the fact that you had a prior biopsy as a marker to indicate that you've had abnormal breast screenings before. It falls into the old where there's smoke there's fire platitude. 

Beesie

I've always sort of wondered about this too.  So I looked it up.  It is exactly as Rose said.  Here's an excerpt from The National Cancer Institute website:

Breast biopsies. Women who have had breast biopsies have an increased risk of breast cancer, especially if the biopsy showed a change in breast tissue, known as atypical hyperplasia. These women are at increased risk because of whatever prompted the biopsies, not because of the biopsies themselves.

http://www.cancer.gov/cancertopics/factsheet/estimating-breast-cancer-risk

The American Cancer Society page goes into more detail.  It doesn't list "previous breast biopsies" as a breast cancer risk factor, but instead says that "abnormal breast biopsy results" may be a risk factor.  They then provide information about which abnormal results do not increase future risk, which ones increase future risk just slightly and which ones are most serious.  This section is about a 1/3 of the way down the page:  http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_breast_cancer_5.asp

So that explains it! 

leaf

But please note that their (ie the Gail model's) ability to predict *your* (in other words any particular individual's) risk of breast cancer is VERY VERY VERY limited - the model is "only slightly better than the roll of dice". (See my post titled Predicting breast cancer in the High Risk Women forum, dated Sept 17, 2007.) , at least for BRCA negative women.


The Gail model predicts well how many women in a population will get breast cancer, but does a really lousy job of predicting precisely *who* those women will be. It is only slightly better if you add more risk factors such as breast density.

Beesie

leaf, I agree.   The article I provided a link to did reference the Gail model, but all that I was using the article for was to answer the question about whether biopsies increase risk, which was the specific question that Melissa asked.  

I didn't mean to open a discussion about the Gail model - I should have been clearer when I provided the link. Getting into a discussion about the Gail model and predicting indivdual risk is a whole different topic that's very complicated and confusing.

roseg

I also think in light of gals being screened with more sensitive methods which have high false positives -digital mammos, MRI- and generate biopsies that the fact you've had a prior biopsy means less than it might have 10 years ago.

Probably a finding of abnormal tissue is a better indicator. 

leaf

I think they simply have a very hard time predicting who will get (non-genetic) breast cancer on an individual level.



The editorial opined that the Gail model should not be used for treatment decisions.



I think it is important to realize that if the risk factors are 'only slightly better than the roll of the dice' when *combined together*, I'm sure they would do even worse when only single risk factors are used to predict breast cancer risk for an individual. (Atypia being another single risk factor in the Gail model.)



If the poster is involved with planning resources for treatment of breast cancer in a population, and is not asking the question for herself or someone (s)he is concerned about, then my apologies to him/her: my comments are not relevant.



People (including me, with LCIS +ALH and nothing worse, and a weak family history, admittedly an unusual situation), want to know what is ahead of them so they can be prepared. It sounds like our current state of knowledge does not allow this.