Faina Nakhlis1,2. 1. Department of Surgery, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA. fnakhlis1@bwh.harvard.edu. 2. Surgical Oncology, Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, 450 Brookline Ave., Boston, MA, 02115, USA. fnakhlis1@bwh.harvard.edu.
Abstract
PURPOSE OF REVIEW: The aim of this review is to summarize recently published literature addressing atypical ductal hyperplasia (ADH), lobular neoplasia (atypical lobular hyperplasia [ALH] and classic lobular carcinoma in situ [C-LCIS]), non-classic lobular carcinoma in situ (NC-LCIS), papillary lesions, and flat epithelial atypia (FEA). RECENT FINDINGS: While ADH, ALN, and C-LCIS are well-established markers of an increased risk of future breast cancers, the risk implications are less clear for papillary lesions and FEA. NC-LCIS is the least well-characterized lesion, with scant published literature on its natural history and surgical management when encountered on needle biopsy. Recent data suggest that lobular neoplasia on core biopsy of a BI-RADS ≤ 4 concordant lesion does not require an excision, while ADH, atypical papillomas, and NC-LCIS should be excised. Evidence on FEA and papillomas without atypia suggests a low risk of upgrade on excision, and prospective studies on the upgrade of these lesions are ongoing.
PURPOSE OF REVIEW: The aim of this review is to summarize recently published literature addressing atypical ductal hyperplasia (ADH), lobular neoplasia (atypical lobular hyperplasia [ALH] and classic lobular carcinoma in situ [C-LCIS]), non-classic lobular carcinoma in situ (NC-LCIS), papillary lesions, and flat epithelial atypia (FEA). RECENT FINDINGS: While ADH, ALN, and C-LCIS are well-established markers of an increased risk of future breast cancers, the risk implications are less clear for papillary lesions and FEA. NC-LCIS is the least well-characterized lesion, with scant published literature on its natural history and surgical management when encountered on needle biopsy. Recent data suggest that lobular neoplasia on core biopsy of a BI-RADS ≤ 4 concordant lesion does not require an excision, while ADH, atypical papillomas, and NC-LCIS should be excised. Evidence on FEA and papillomas without atypia suggests a low risk of upgrade on excision, and prospective studies on the upgrade of these lesions are ongoing.
Entities:
Keywords:
Atypical ductal hyperplasia (ADH); Flat epithelial atypia (FEA); Lobular neoplasia (atypical lobular hyperplasia (ALH) and classic lobular carcinoma in situ (C-LCIS)); Non-classic lobular carcinoma in situ (NC-LCIS); Papillary breast lesions
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