A 30-year-old woman has cyclic bilateral breast pain and nodularity that worsens before menstruation. Biopsy shows cysts, apocrine metaplasia, and mild epithelial hyperplasia without atypia. What is her relative risk of subsequently developing invasive breast carcinoma compared with the general population?
- A 4 to 5 times increased
- B 1.5 to 2 times increased
- C No significant increase (approximately 1-fold) ✓
- D 10 times increased
Correct answer: C. No significant increase (approximately 1-fold)
Explanation
Nonproliferative fibrocystic change, including cysts, apocrine metaplasia, and mild hyperplasia without atypia, carries no increased risk of subsequent carcinoma. The risk rises only with proliferative lesions: usual ductal hyperplasia or sclerosing adenosis confers about 1.5 to 2 times risk, while atypical ductal or lobular hyperplasia confers 4 to 5 times risk. This stratification from Robbins is a standard exam point.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.