Article ; Online: Value of Long-term Follow-up in Surgically Excised Lesions of Uncertain Malignant Potential in the Breast - Is 5 Years Necessary?
2022 Volume 22, Issue 7, Page(s) 699–704
Abstract: Introduction: B3 lesions are a heterogeneous group of breast lesions of uncertain malignant potential which usually require excision. The aim was to assess the efficacy of 5 years routine radiological or clinical follow-up of patients who had "high-risk" ...
| Abstract | Introduction: B3 lesions are a heterogeneous group of breast lesions of uncertain malignant potential which usually require excision. The aim was to assess the efficacy of 5 years routine radiological or clinical follow-up of patients who had "high-risk" B3 lesions surgically excised, by analyzing recurrence and subsequent development of invasive/in-situ cancer. Patients and methods: A 10-year retrospective review from 2010 to 2019 was performed of B3 lesions diagnosed on core needle biopsy, including patients who proceeded to surgical excision with a high-risk lesion on final histology. The database recorded 6 specific B3 lesion categories: 1. Atypical ductal hyperplasia (ADH), 2. Radial scars/complex sclerosing lesions (CSLs) with epithelial atypia 3. Classical Lobular neoplasia (ALH/LCIS), 4. Papillary lesions with epithelial atypia, 5. Mixed, 6. Flat epithelial atypia (FEA), including radiological and clinical follow-up data. Results: Six hundred sixteen patients had a B3 lesion after core biopsy. 110 patients had "high risk" lesions. This included 17 (15.5%) Atypical Ductal Hyperplasia (ADH), 22 (20%) radial scars/CSLs with epithelial atypia, 47 (42.7%) classical lobular neoplasia (LCIS/ALH), 7 (6.4%) papillary lesions with epithelial atypia, 13 (11.8%) mixed lesions & 4 (3.6%) Flat Epithelial Atypia (FEA) lesions. 4 of 110 (3.6%) developed invasive/in-situ disease and 4 of 110 (3.6%) developed recurrence during follow-up. 33 of 616 (5.4%) upgraded to invasive/preinvasive disease after surgical excision. Conclusion: Five years of routine radiological surveillance may not be necessary in patients who undergo surgical excision of "high-risk" B3 lesions. Clinical surveillance appears to be of little benefit, especially in patients with radial scars, papillary lesions, and FEA. Subsequent development of invasive/in-situ disease in patients who undergo surgical excision of atypical B3 lesions remains low. |
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| MeSH term(s) | Biopsy, Large-Core Needle ; Breast/diagnostic imaging ; Breast/pathology ; Breast/surgery ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Carcinoma in Situ ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Cicatrix/etiology ; Female ; Fibrocystic Breast Disease/pathology ; Follow-Up Studies ; Humans ; Mammography ; Precancerous Conditions/pathology ; Retrospective Studies |
| Language | English |
| Publishing date | 2022-06-02 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2106734-X |
| ISSN | 1938-0666 ; 1526-8209 |
| ISSN (online) | 1938-0666 |
| ISSN | 1526-8209 |
| DOI | 10.1016/j.clbc.2022.05.009 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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