TY - JOUR
T1 - Upgrade of high-risk breast lesions detected on mammography in the Breast Cancer Surveillance Consortium
AU - Menes, Tehillah S.
AU - Rosenberg, Robert
AU - Balch, Steven
AU - Jaffer, Shabnam
AU - Kerlikowske, Karla
AU - Miglioretti, Diana L.
N1 - Funding Information:
This work was supported by the National Cancer Institute –funded Breast Cancer Surveillance Consortium (grants U01CA63740 , U01CA86076 , U01CA86082 , U01CA63736 , U01CA70013 , U01CA69976 , U01CA63731 , U01CA70040 , and HHSN261201100031C ). The collection of cancer and vital status data used in this study was supported in part by several state public health departments and cancer registries throughout the United States. For a full description of these sources, please see http://breastscreening.cancer.gov/work/acknowledgement.html .
PY - 2014/1
Y1 - 2014/1
N2 - Background Upgrade rates of high-risk breast lesions after screening mammography were examined. Methods The Breast Cancer Surveillance Consortium registry was used to identify all Breast Imaging Reporting and Data System category 4 assessments followed by needle biopsies with high-risk lesions. Follow-up was performed for all women. Results High-risk lesions were found in 957 needle biopsies, with excision documented in 53%. Most (n = 685) were atypical ductal hyperplasia (ADH), 173 were lobular neoplasia, and 99 were papillary lesions. Upgrade to cancer varied with type of lesion (18% in ADH, 10% in lobular neoplasia, and 2% in papillary lesions). In premenopausal women with ADH, upgrade was associated with family history. Cancers associated with ADH were mostly (82%) ductal carcinoma in situ, and those associated with lobular neoplasia were mostly (56%) invasive. During a further 2 years of follow-up, cancer was documented in 1% of women with follow-up surgery and in 3% with no surgery. Conclusions Despite low rates of surgery, low rates of cancer were documented during follow-up. Benign papillary lesions diagnosed on Breast Imaging Reporting and Data System category 4 mammograms among asymptomatic women do not justify surgical excision.
AB - Background Upgrade rates of high-risk breast lesions after screening mammography were examined. Methods The Breast Cancer Surveillance Consortium registry was used to identify all Breast Imaging Reporting and Data System category 4 assessments followed by needle biopsies with high-risk lesions. Follow-up was performed for all women. Results High-risk lesions were found in 957 needle biopsies, with excision documented in 53%. Most (n = 685) were atypical ductal hyperplasia (ADH), 173 were lobular neoplasia, and 99 were papillary lesions. Upgrade to cancer varied with type of lesion (18% in ADH, 10% in lobular neoplasia, and 2% in papillary lesions). In premenopausal women with ADH, upgrade was associated with family history. Cancers associated with ADH were mostly (82%) ductal carcinoma in situ, and those associated with lobular neoplasia were mostly (56%) invasive. During a further 2 years of follow-up, cancer was documented in 1% of women with follow-up surgery and in 3% with no surgery. Conclusions Despite low rates of surgery, low rates of cancer were documented during follow-up. Benign papillary lesions diagnosed on Breast Imaging Reporting and Data System category 4 mammograms among asymptomatic women do not justify surgical excision.
KW - Atypical ductal hyperplasia
KW - Atypical lobular hyperplasia
KW - High-risk breast lesions
KW - Lobular neoplasia
KW - Papillary lesions
KW - Upgrade
UR - http://www.scopus.com/inward/record.url?scp=84890328751&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2013.05.014
DO - 10.1016/j.amjsurg.2013.05.014
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C2 - 24112677
AN - SCOPUS:84890328751
SN - 0002-9610
VL - 207
SP - 24
EP - 31
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 1
ER -
