Evaluation of breast cancer risk associated with atypical hyperplasia of the lobular and ductal types in a jamaican hospital 2007-2012: across-sectional study

Background: There is a paucity of significant data with regards to the high prevalence of breast cancer and its risk factors within the parish of Manchester. Atypical hyperplasia with a relative risk of 4-5% 5 has been demonstrated to have a positive association with the development of breast cancer. The objective the study is to clearly and concisely assess the association between atypical hyperplasia and breast cancer from convenient data obtain at a central Jamaica hospital over a five-year period. Method: This study is essentially an analytical cross-sectional study in which the risk factor(s), atypical hyperplasia and associated outcome(s), and breast cancer are analysed within the same time frame. The data for all breast related surgical procedures during 2007 until 2012 were collated and the subset of patients who had atypical hyperplasia and breast cancer were selected for analysis. The descriptive statistics were conducted to included estimates of central tendencies and dispersion for quantity of procedures done, types of pathologies observed, age and gender of the patients. Additional evaluation included Pearson’s correlation and linear regression. The cohort of patients with atypical hyperplasia and non-benign lesions were further selected for risk factor analysis and predictive risk assessment for breast cancer. Results: The quantity of procedure done during the study period was 551 however, this did not reflect the quantity of complete histopathology reports due to that fact that there were missing data. The total sample size of persons was 147 which was predominantly females (142) and with a total of 210 breast pathologies of which 158 were benign breast disease (BBD), 4 were atypical hyperplasia (AH) and 48 were non-benign lesions. The linear regression analysis done demonstrated this equation; non-benign lesion = (2.7)*(atypical hyperplasia) + 6.2 where 2.7 is the gradient and 6.2 the intercept. The Pearson’s correlation analysis demonstrated a weak association with a p-value .213. The risk factors of; age at menarche (14 years), number of first degree relatives with breast cancer (1.3persons), age at current biopsy (57 years), age at first live birth (20 years), were the most salient among the cohort of atypical hyperplasia and non-benign lesion. Conclusion: There was a positive weak association between atypical hyperplasia and non-benign lesions which were not statistically significant, which could be attributed to the missing data which made the study under powered.