RT Book, Section
A1 Degnim, Amy C.
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145760042
T1 High-Risk Breast Pathology
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145760042
RD 2024/04/20
AB The  phrase  “high-risk  breast  pathology”  has  two  meanings.  Classically,  it  refers  to  specific  histologic  findings  in  breast  biopsy  tissue  that  portend  an  increased  risk  of  breast  cancer  for  a  woman  in  the  years  after  the  breast  biopsy.  With  the  shift  in  recent  years  from  surgical  excision  of  breast  lesions  to  the  routine  use  of  percutaneous  biopsy  for  diagnosis,  high-risk  breast  pathology  has  also  taken  on  a  second  meaning—breast  lesions  identified  at  percutaneous  biopsy  that  may  be  malignant  but  are  not  adequately  diagnosed  with  the  percutaneous  approach  and  therefore  require  surgical  excision  for  definitive  exclusion  of  malignancy.  Thus,  they  are  “high-risk”  because  they  indicate  a  substantial  risk  that  cancer  is  currently  present  in  the  breast  at  the  needle  biopsy  site.  Classic  high-risk  lesions  with  proven  increase  in  long-term  breast  cancer  risk  include  lobular  carcinoma  in  situ  (LCIS),  atypical  lobular  hyperplasia  (ALH),  and  atypical  ductal  hyperplasia  (ADH).  Other  high-risk  breast  pathology  lesions  with  less  long-term  risk  but  with  concern  for  upgrade  after  needle  biopsy  include  flat  epithelial  atypia,  radial  scar,  and  papillary  lesions.  This  chapter  will  address  both  aspects  of  increased  risk  for  these  lesions—long-term  increase  in  breast  cancer  risk  as  well  as  the  risk  of  “upgrade”  to  cancer  with  surgical  excision  of  the  percutaneous  biopsy  site.