Cohort study of association of risk of breast cancer with cyst type in women with gross cystic disease of the breast

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Abstract
Objective: To assess correlation between type of breast cyst and risk of breast cancer in women with gross cystic disease of the breast. Design: Cohort study of women with breast cysts aspirated between 1983 and 1993 who were followed up until December 1994 for occurrence of breast cancer. Setting: Major cancer prevention centre. Subjects: 802 women with aspirated breast cysts. Main outcome measures: Type of breast cyst based on cationic content of cyst fluid: type I (potassium:sodium ratio >1.5), type II (potassium:sodium ratio Results: After median follow up of six years (range 2-12 years) 15 cases of invasive breast cancer and two ductal carcinomas in situ were diagnosed in the cohort: 12 invasive cancers (and two carcinomas in situ) among the 417 women with type I cysts, two cancers among the 325 women with type II cysts, and one among the 60 women with mixed cysts. The incidence of breast cancer in women with type I cysts was significantly higher than that in women with type II cysts (relative risk 4.62 (95% confidence interval 1.26 to 29.7)). These results were confirmed after adjustment for several risk factors for breast cancer (relative risk 4.24 (1.12 to 27.5)). Conclusions: The increased risk of breast cancer of women with breast cysts seems to be concentrated among women with type I breast cysts. Several studies have shown that women with palpable cysts in their breasts are at increased risk of breast cancer Two types of breast cyst can be identified–type I cysts, with low concentrations of sodium and high concentrations of potassium ions, and type II cysts, with opposite characteristics We investigated the correlation between cyst type and risk of breast cancer in 802 women with aspirated breast cysts After median follow up of six years, the women had a relative risk of breast cancer of 1.69 compared with the general population, and those with type I cysts had a risk four times higher than those with type II cysts The excess risk of breast cancer of women with breast cysts seems to be concentrated among women with type I cysts, but the size and duration of this increased risk are still to be assessed

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