~~Daniel W. Visscher, MD is a Consultant in the Division of Anatomical Pathology at Mayo Clinic, Rochester, MN.  He has over 30 years of experience in daily sign-outs on general surgical pathology services during which he has contributed to the training of innumerable residents and fellows.  He participates in a busy extramural specialty practice at Mayo which provides consultations for difficult and/or unusual breast biopsies.  Over the course of his career, Dr. Visscher has functioned as a Pathology Course Director (Wayne State University), a Surgical Pathology Director (University of Michigan) and Biospecimen Core Director for Mayo Clinic’s Breast SPORE grant.  He is a lifelong runner and passionate gardener.

~~Description:  Using a combined epidemiologic - pathologic approach, Dupont and Page established the relationship between certain histological forms of benign breast disease (BBD), particularly atypical hyperplasias (AH), and risk for subsequent development of breast cancer.  Their studies were often interpreted to imply a sequence of increasingly dramatic cellular proliferation which culminated in malignancy.  However, deconvolution of early breast cancer pathogenesis has been frustrated by the lengthy natural history, considerable heterogeneity and mechanistic complexity of this disease; these factors have all imposed formidable barriers to breast cancer prevention through as well as to improved (“individualized”) risk assessment for women with BBD.  The Mayo BBD cohort, a single institution  longitudinal analysis of over 10000 women who underwent at least one benign breast biopsy, has  confirmed and extended Dupont and Page’s observations.  This presentation will summarize current research utilizing the Mayo BBD cohort.  It will focus on how systemic/constitutional tissue-based changes can provide hypotheses to be tested for eventually clarifying the underlying basis of breast cancer etiology and progression.