scholarly journals Risky Business: Audit of the Surgical Upgrade Rate of Atypical Ductal Hyperplasia, a High Risk Breast Lesion.

2020 ◽  
Author(s):  
Csilla Egri ◽  
Juvel Lee ◽  
Marguerite Nguyen ◽  
Christine Wilson ◽  
Charlotte Yong-Hing
Keyword(s):  
High Risk ◽  
Breast Lesion ◽  
Atypical Ductal Hyperplasia ◽  
Ductal Hyperplasia ◽  
Risky Business ◽  
High Risk Breast

Role of one-pass breast lesion excision system in complete excision of high-risk breast lesions with atypia expressed as clusters of microcalcifications

2019 ◽  
Vol 29 (6) ◽  
pp. 3149-3158 ◽  
Author(s):  
Alexandra Christou ◽  
Vassilis Koutoulidis ◽  
Dimitra Koulocheri ◽  
Evangelia Panourgias ◽  
Afrodite Nonni ◽  
...  
Keyword(s):  
High Risk ◽  
Breast Lesion ◽  
Breast Lesions ◽  
Complete Excision ◽  
High Risk Breast

scholarly journals What Happens after a Diagnosis of High-Risk Breast Lesion at Stereotactic Vacuum-assisted Biopsy? An Observational Study of Postdiagnosis Management and Imaging Adherence

Radiology ◽  
2018 ◽  
Vol 287 (2) ◽  
pp. 423-431 ◽  
Author(s):  
Yiming Gao ◽  
Marissa Albert ◽  
Leng Leng Young Lin ◽  
Alana A. Lewin ◽  
James S. Babb ◽  
...  
Keyword(s):  
High Risk ◽  
Observational Study ◽  
Breast Lesion ◽  
Stereotactic Vacuum Assisted Biopsy ◽  
High Risk Breast

High-Risk Breast Lesions

2017 ◽  
Author(s):  
Richard J Bleicher
Keyword(s):  
High Risk ◽  
Atypical Ductal Hyperplasia ◽  
Lobular Carcinoma ◽  
Breast Disease ◽  
Lobular Neoplasia ◽  
Radial Scar ◽  
Imaging Evaluation ◽  
Usual Ductal Hyperplasia ◽  
Ductal Hyperplasia ◽  
Papillary Lesions

Clinicians who treat breast disease deal with a variety of pathologic findings. Although there is often a focus on paradigms and data regarding malignant breast disease, benign breast disease ranges from that which requires no imaging, evaluation, or treatment to that which requires further testing to rule out concomitant cancer and ameliorate subsequent risk. This review discusses the most frequent types of high-risk lesions facing the breast practitioner, including atypical ductal hyperplasia, lobular neoplasia, radial scar, and papillary lesions. It is critical that the clinician understand the implications of each finding to advise about the risks associated with each of these entities, fully assess the need for further therapy, and mitigate the patient’s future risk.  This review contains 2 tables, and 69 references. Key words: atypical ductal hyperplasia, atypical lobular hyperplasia, lobular neoplasia, lobular carcinoma in situ, papillary lesions, pleomorphic, pseudoangiomatous stromal hyperplasia, radial scar, usual ductal hyperplasia

Management of the High-Risk Breast Lesion

2014 ◽  
pp. 93-112
Author(s):  
Jared Linebarger ◽  
Jon Zellmer ◽  
Monica Rizzo
Keyword(s):  
High Risk ◽  
Breast Lesion ◽  
High Risk Breast

scholarly journals Atypical Ductal Hyperplasia and Those Bordering on Ductal Carcinoma In Situ Should Be Included in the Active Surveillance Clinical Trials

2019 ◽  
Vol 153 (1) ◽  
pp. 131-138 ◽  
Author(s):  
Thaer Khoury ◽  
Nashwan Jabbour ◽  
Xuan Peng ◽  
Li Yan ◽  
Marie Quinn
Keyword(s):  
Clinical Trials ◽  
High Risk ◽  
Active Surveillance ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Atypical Ductal Hyperplasia ◽  
Screening Mammography ◽  
Ductal Hyperplasia

Abstract Objectives Women with atypical ductal hyperplasia (ADH), unlike those with ductal carcinoma in situ (DCIS), are denied eligibility for active surveillance clinical trials. Methods We applied the inclusion criteria of the Comparison of Operative to Monitoring and Endocrine Therapy (COMET) trial to the cases of women (n = 165) at the Roswell Park Cancer Institute who had a diagnosis of ADH, ADH bordering on DCIS, or low- to intermediate-grade DCIS on core biopsy taken during screening mammography. Upgrade of lesions to high risk was based on invasive carcinoma, high-grade DCIS, or DCIS with comedo necrosis. Results In total, nine (5.5%) lesions were upgraded: two (1.7%) reported ADH, one (5.9%) reported ADH bordering on DCIS, and six (19.4%) reported DCIS (P = .002); and two (1.6%) reclassified ADH vs seven (17.1%) reclassified DCIS (P < .001). In multivariate analysis, only increased number of foci had the potential to predict high risk (odds ratio: 1.39; P = .06). Conclusions We conclude that ADH and ADH bordering on DCIS have lower upgrade rates than DCIS. We recommend opening an active surveillance clinical trial for women with these diagnoses.

scholarly journals A program to increase use of chemoprevention for women with high-risk breast lesions.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 46-46 ◽  
Author(s):  
Constance A. Roche ◽  
Kevin S. Hughes
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Cancer Risk ◽  
Ovarian Cancer Risk ◽  
Breast Clinic ◽  
High Risk Women ◽  
Ductal Hyperplasia ◽  
High Risk Breast ◽  
Prevention Clinic

46 Background: Tamoxifen, raloxifene, and exemestane have been demonstrated to reduce risk of breast cancer in high-risk women, bututilization is very low.Among the reasons cited are lack of awareness and reluctance of physicians to prescribe. Women with high-risk breast lesions are generally candidates for chemoprevention and can be evaluated and counseled in a high-risk breast clinic. Knowledge about drugs that can prevent breast cancer may increase uptake among high-risk women. Methods: In a single practice, women with a diagnosis of atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), or severe atypical ductal hyperplasia/borderline ductal carcinoma in situ are offered an extended visit with a nurse practitioner in the Breast and Ovarian Cancer Risk and Prevention Clinic. The visit includes data collection, patient interview about relevant history and personal preferences, risk assessment, including use of relevant models (via HughesRiskApps.com), and recommendations for surveillance and prevention. Emphasis is placed on understanding of individual risk as well as risks and benefits and appropriateness of chemoprevention and surveillance modalities. Based on personal and family history, women are advised if chemoprevention is appropriate to consider, their choice is made, and they are encouraged to have surveillance in the Breast Clinic. Results: Since January 2001, 487 women with a diagnosis of ADH, ALH or LCIS, or severe ADH have been evaluated and counseled in the Breast and Ovarian Cancer Risk and Prevention Clinic. 132/487 (27%) were advised against taking chemoprevention and 355/487 (73%) were appropriate for chemoprevention. Of those for whom chemoprevention was clinically appropriate, 188/355 (53%) took one of the medications, or participated in a chemoprevention trial. 53/188 (28%) did not complete therapy (discontinued at 2 weeks to 54 months) due to preference or side effects. 75 women have completed five years of therapy and 60 are currently on therapy. Conclusions: When provided with personalized information about breast cancer risk and the pros and cons of chemoprevention, many women will choose to take medication to reduce breast cancer risk.

High-Risk Breast Lesions

2017 ◽  
Author(s):  
Richard J Bleicher
Keyword(s):  
High Risk ◽  
Atypical Ductal Hyperplasia ◽  
Lobular Carcinoma ◽  
Breast Disease ◽  
Lobular Neoplasia ◽  
Radial Scar ◽  
Imaging Evaluation ◽  
Usual Ductal Hyperplasia ◽  
Ductal Hyperplasia ◽  
Papillary Lesions

Clinicians who treat breast disease deal with a variety of pathologic findings. Although there is often a focus on paradigms and data regarding malignant breast disease, benign breast disease ranges from that which requires no imaging, evaluation, or treatment to that which requires further testing to rule out concomitant cancer and ameliorate subsequent risk. This review discusses the most frequent types of high-risk lesions facing the breast practitioner, including atypical ductal hyperplasia, lobular neoplasia, radial scar, and papillary lesions. It is critical that the clinician understand the implications of each finding to advise about the risks associated with each of these entities, fully assess the need for further therapy, and mitigate the patient’s future risk.  This review contains 2 tables, and 69 references. Key words: atypical ductal hyperplasia, atypical lobular hyperplasia, lobular neoplasia, lobular carcinoma in situ, papillary lesions, pleomorphic, pseudoangiomatous stromal hyperplasia, radial scar, usual ductal hyperplasia

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