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Breast Disease, fibrocystic, breast cyst
A. 182,000 women in United States
B. 46,000 deaths
C. 2% per year rate increase
D. One in nine women by age 85
E. Survival unchanged since 1930
F. 75 % no risk factors
G. Age 1. < 30 years: 1% 2. 30s: 6% 3. 40s: 17% 4. 50 and older: 75%
H. Specific risk
Table 1
Magnitude of fibrosystic
Risk Factor High-Risk Group Low-Risk Group Differential
Age Old Young
Country of birth North America, Asia, Africa
Socioeconomic status High Low ~[
Marital status Never married Ever married
Place of residence Urban Rural
Northern US Southern US ~/
Race: > 45 years White Black
< 40 years Black White
Nulliparity Yes No ~/
Age at first full-term pregnancy > 30 years < 20 years ~
Oophorectomy premenopausally' No Yes ~
Age at menopause Late Early
Age at menarche Early Late
Weight, postmenopausal women Heavy Thin
History of cancer in one breast Yes No ~ syst cist
History of benign proliferative lesion Yes No ~
Any/first-degree relative with history Yes No ~
of breast cancer
i
Mother and sister with history of Yes No ]~ ~
breast cancer
History of primary cancer in Yes No ~i~
endometrium or ovary
Mammographic parenchymal patterns ~
parenchyma
Radiation to chest Large doses Minimal exposure ~
I
= denotes relative risk of 1.1-1.9
~ = denotes relative risk of 2.0--4.0
~ ~ = denotes relative risk of > 4.0
Table 2
Risk Factor History: What Questions Should You Ask?
The best way to assess a patient's breast cancer risk is historical, and you should obtain answers to the following questions
· How old are you?
· How old were you when you had your first menstrual period?
· Have you ever given birth to a live or stillborn child? How many times? How old were you when you first gave birth?
· Do you still menstruate?