For 20 years, we have sought to further understanding of the epidemiology and natural history of benign and malignant breast diseases through studies of breast fluid obtained from nipple aspiration, currently the only feasible noninvasive method to assess breast epithelium and its biochemical milieu. Our long-range goals for this research are to identify women at high risk for breast cancer using cytologic and biochemical markers, and to understand how breast cancer risk factors influence breast fluid biochemistry and premalignant cytologic conditions. In our most recent projects, we collected pertinent new biologic and epidemiologic data from three populations. We now require two additional years of funding to analyze these new data and prepare scientific communications. The three primary goals of our proposed analyses are: 1) to quantify the risks and modifications of risk of breast cancer and histologically defined benign breast disease associated with prior atypical breast fluid cytologic findings by multivariate survival analyses. We are uniquely able to determine prospectively the breast cancer risk associated with prior cytologic findings because our 4392 study subjects comprise the only large group of women with breast fluid cytology obtained 10-20 years ago; 2) to investigate the as-yet unexplored interrelationships of breast cancer risk factors including diet with breast fluid and mammographic findings. These analyses use data collected from women attending the university mammography clinic (n-1087) and from university employee volunteers (n=868). These studies will provide new information on the associations of established risk factors, diet, breast fluid secretion, cytology, and biochemistry, and mammography. This work may elucidate mechanisms by which dietary factors influence breast disease. It will also extend our prior findings on associations of breast disease risk factors with breast fluid cytology and biochemistry; and 3) to analyze long-term stability in breast fluid secretion, cytology, cholesterol, and cholesterol beta-epoxide in university employees seen over a 2.5-year period at six-month intervals. Together, analyses of these newly collected data will contribute to a comprehensive understanding of the natural history of benign and malignant breast diseases that may help enable informed clinical counseling and may ultimately lead to disease prevention.
