Prevention, Risk and Screening »Risk Assessment at Fox Chase »Breast and Ovarian Cancer

For Women with Benign Breast Disease

If you have had a biopsy showing benign breast disease (a non-cancerous abnormality), you may be at increased risk for breast cancer. Know your breast cancer risk, how to reduce it and how to advance what is known about benign breast disease and its link to breast cancer. Be proactive. BeBrave.

BeBrave, or the Benign Breast Registry to Assess Valid Endpoints, at Fox Chase is for women with a diagnosis of benign breast disease based on breast biopsy. Its purpose is to learn more about the biological signs of benign lesions (areas of abnormal tissue) and the clinical care decisions faced by women with this diagnosis.

Women who are eligible for the registry are enrolled through the Risk Assessment Program at Fox Chase. This program offers risk assessment and prevention services for women at increased risk for breast cancer due to factors such as benign breast disease.

What is benign breast disease?

Benign breast disease is a common condition marked by benign (noncancerous) changes in breast tissue identified by mammogram or ultrasound or diagnosed by biopsy. These changes may include benign lumps or cysts.

Benign breast disease is not life-threatening. But, certain benign conditions are linked with an increased risk of getting breast cancer.

Changes that may increase your chances of getting breast cancer:

• Atypical Ductal or Lobular Hyperplasia (ADH or ALH): Abnormal cells found in the breast ducts or lobules.

  Ducts are pathways in the breast through which milk passes from the lobules to the nipple during lactation. Lobules are spherical-shaped sacs in the breast that produce milk.

  ADH and ALH are considered intermediate markers for breast cancer. Close follow-up in the form of twice yearly clinical breast exams and a yearly mammogram is usually recommended. ADH and ALH do not always progress to cancer.

• Lobular Carcinoma In Situ (LCIS): Abnormal cells found in the breast lobules. A higher level of breast cancer risk is associated with LCIS than with ADH or ALH.

  Despite the name, LCIS is not cancer. It is not usually found during a breast exam but when breast tissue is removed (biopsy) and examined by a pathologist. LCIS is thought to be a marker for cancer risk. However, it is not thought to be a cause of breast cancer, nor does LCIS itself become an invasive cancer.

  Women with LCIS require close follow-up with their physician with exams typically every 6 months and a yearly mammogram. Some women also choose to take tamoxifen to further reduce their breast cancer risk.

Having ADH, ALH or LCIS in one breast means that you may have a higher risk of getting cancer in either breast.

What is a breast biopsy?

The only way to tell if an abnormality is breast cancer or benign breast disease is to have a breast biopsy. During a biopsy, the doctor removes cells or tissues from the breast. This biopsy specimen is then sent to a lab where a doctor called a pathologist studies it under a microscope. At Fox Chase, our world-class pathologists provide the highest level of expertise for the most accurate diagnosis.

You may need to have a biopsy if you experience symptoms or if a screening mammogram detects breast changes. Symptoms may include a lump or area of thickening found while checking your breasts or during a clinical breast exam by your doctor. Pain or a discharge (other than milk) from the nipple also may indicate benign breast disease. It is important to know that most abnormal findings are not cancer.

Biopsies are usually done on an outpatient basis, meaning you can go home the same day as your procedure.

Why BeBrave?

Widespread use of screening mammography has made it possible to find early breast lesions. As a result, more women are being referred for breast biopsies. For women diagnosed with benign breast disease after a biopsy, there are no clear guidelines for physicians to follow in their care. New tests are needed to help define risk levels and aid in management of these women.

Mary B. Daly, MD, PhD, founder of Fox Chase's Risk Assessment Program, and Fox Chase geneticist Andrew Godwin, PhD, developed BeBrave to address this area of research.

The BeBrave registry collects medical information and specimen samples from previous breast biopsies showing benign breast disease. All of your records are kept confidential. Your sample is used only for the purposes of this research.

One of the goals is to find new and better ways to predict which benign findings need closer follow-up. Two promising new tools that may further our understanding of the beginning of breast cancer are:

• Laser capture microdissection: A specialized cutting method to get cells from breast tissue, which may show whether or not there are early changes that may be responsible for benign breast disease.

• Proteomic typing of breast tissue: A tool that "fingerprints" different proteins found in breast tissue.

The BeBrave program's research may identify new markers that will better predict the risk of developing invasive breast cancer in women with benign breast disease.

For more information about benign breast disease or to learn how you can participate in the BeBrave program at Fox Chase Cancer Center, call Beth Stearman at 1-877-627-9684 or 215-214-1411.

For more information about the Risk Assessment Program at Fox Chase Cancer Center, call the program at 1-877-627-9684.