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November 1, 1985

Caffeine and Benign Breast Disease-Reply

Author Affiliations

Sheba Medical Center Israel

JAMA. 1985;254(17):2408-2409. doi:10.1001/jama.1985.03360170048012

In Reply.—  Dr Minton's letter shows a basic misunderstanding of our study's aims and its methods. Our objective was to investigate if there is an etiological association between methylxanthine intake and all types of well-differentiated benign breast diseases, diagnosed by histopathological findings after biopsy. We did not evaluate the possible therapeutic effect of a methylxanthine-free diet. His letter states that fibroadenoma, nonspecific histopathology, and granuloma are irrelevant in a study evaluating the effects of caffeine on benign breast disease. Yet Minton has reported that methylxanthine acts on breast tissue by increasing the level of cyclic adenosine monophosphate and cyclic guanosine monophosphate and shows that this effect is common to all benign breast disease, including fibroadenoma.1 Furthermore, he finds this effect peaks in breast cancer tissue. Our study population, graded by Black's system of degree of ductal atypia (from grade 1, normotypic, through grades 3 and 4, precancerous mastopathy, to