Pathologic High-risk Lesions, Diagnosis and Management

Murray, Melissa P.

doi:10.1097/grf.0000000000000234

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…A review of the available literature shows that ADH is often associated with a significantly higher risk of concomitant DCIS and/or invasive carcinoma (IC) diagnosed by subsequent surgical excisions [ 5 , 6 , 7 , 8 , 9 ]. Although debate on this subject still exists, the diagnosis of ADH is an indication for surgery [ 3 , 6 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?

et al. 2021

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(1) Background: to evaluate which factors can reduce the upgrade rate of atypical ductal hyperplasia (ADH) to in situ or invasive carcinoma in patients who underwent vacuum-assisted breast biopsy (VABB) and subsequent surgical excision. (2) Methods: 2955 VABBs were reviewed; 141 patients with a diagnosis of ADH were selected for subsequent surgical excision. The association between patients’ characteristics and the upgrade rate to breast cancer was evaluated in both univariate and multivariate analyses. (3) Results: the upgrade rates to ductal carcinoma in situ (DCIS) and invasive carcinoma (IC) were, respectively, 29.1% and 7.8%. The pooled upgrade rate to DCIS or IC was statistically lower at univariate analysis, considering the following parameters: complete removal of the lesion (p-value < 0.001); BIRADS ≤ 4a (p-value < 0.001); size of the lesion ≤15 mm (p-value: 0.002); age of the patients <50 years (p-value: 0.035). (4) Conclusions: the overall upgrade rate of ADH to DCIS or IC is high and, as already known, surgery should be recommended. However, ADH cases should always be discussed in multidisciplinary meetings: some parameters appear to be related to a lower upgrade rate. Patients presenting these parameters could be strictly followed up to avoid overtreatment.

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Section: Introductionmentioning

confidence: 99%

Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?

et al. 2021

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“…1, 16 AH is a major precancerous lesion, 17 and early treatment and monitoring during this important pathological stage can have significant impacts on the incidence of breast cancer. 5 However, the current large-scale epidemiological investigation showed that breast AH cannot be diagnosed and monitored accurately based on clinical features and risk factors. AH is characterized by filling and distention of the involved ducts by monotonous epithelial cells forming architecturally complex patterns, including cribriform-like secondary lumens or micropapillary formations.…”

Section: Discussionmentioning

confidence: 99%

“…The breast cancer progression model introduced by Wellings and Jensen 4 initially suggested that normal cells in the terminal ductal lobular unit first progress to atypical hyperplasia (AH), then develop into ductal carcinoma in situ, and finally to invasive carcinoma. Preventing the malignant transformation of breast AH cells could significantly decrease the occurrence of cancer, 2,5 and understanding the pathologic stage of AH is thus extremely important in terms of the clinical diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Molecular fingerprint of precancerous lesions in breast atypical hyperplasia

et al. 2020

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Objective To identify atypical hyperplasia (AH) of the breast by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS), and to explore the molecular fingerprinting characteristics of breast AH. Methods Breast hyperplasia was studied in 11 hospitals across China from January 2015 to December 2016. All patients completed questionnaires on women’s health. The differences between patients with and without breast AH were compared. AH breast lesions were detected by Raman spectroscopy followed by the SHINERS technique. Results There were no significant differences in clinical features and risk-related factors between patients with breast AH (n = 37) and the control group (n = 2576). Fifteen cases of breast AH lesions were detected by Raman spectroscopy. The main different Raman peaks in patients with AH appeared at 880, 1001, 1086, 1156, 1260, and 1610 cm−1, attributed to the different vibrational modes of nucleic acids, β-carotene, and proteins. Shell-isolated nanoparticles had different enhancement effects on the nucleic acid, protein, and lipid components in AH. Conclusion Raman spectroscopy can detect characteristic molecular changes in breast AH lesions, and may thus be useful for the non-invasive early diagnosis and for investigating the mechanism of tumorigenesis in patients with breast AH.

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“…La denominación de cicatriz radial por lo regular se usa en lesiones de hasta 1 cm (una de mayor tamaño es lesión esclerosante compleja). 9,10 Su diagnóstico era incidental en la evaluación microscópica, pero recientemente su sospecha ha aumentado por mayor acceso a la mamografía 11,12 en la que se presenta como un área de distorsión arquitectónica, 5 acompañada de otros criterios: 1) presencia de una radiolucidez central, 2) espículas radiadas delgadas, largas, 3) apariencia diferente según las proyecciones, 4) estructuras lineales radiolúcidas paralelas a las espículas y 5) ausencia de lesiones palpables o cambios en la piel. 13 En el ultrasonido son visibles como masas hipoecoicas irregulares con sombreado posterior prácticamente idénticas al aspecto del cáncer de mama.…”

Section: Discusionunclassified

Cáncer de mama cercano a cicatriz radial

Mariño¹

2022

Cirujano General

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Introducción: el cáncer de mama es la principal causa de muerte a nivel mundial, la cicatriz radial es una lesión de alto riesgo para el desarrollo de cáncer, actualmente existe controversia respecto al tratamiento de estas lesiones. Objetivo: revisar publicaciones que evalúen y mensuren la presencia de cáncer de mama en proximidad del sitio de biopsia percutánea de cicatriz radial. Material y métodos: revisión sistemática en la base de datos de PubMed, con los términos breast radial scar and neoplasms, buscando artículos con diagnóstico único de cicatriz radial por biopsia percutánea y posterior biopsia abierta con hallazgo de neoplasia maligna de mama, separada del sitio de la primera biopsia y confirmada por medición de la distancia entre las dos lesiones. Resultados: se encontraron 242 publicaciones. De éstas, se excluyeron 108 en el cribado por título y resumen, 28 de ellas por tratarse de artículos de revisión. Se excluyeron dos artículos en alemán, cinco presentaciones de casos, una carta y un comentario. Las demás se excluyeron por no corresponder al objetivo de la investigación. De la revisión restante, fueron seleccionados dos artículos para análisis cualitativo. Conclusiones: este estudio revisa la presencia de cáncer de mama por fuera del sitio de biopsia de cicatriz radial pura. A pesar de la baja frecuencia de esta localización, se considera que la biopsia por escisión es el enfoque adecuado después de la biopsia percutánea porque permite el diagnóstico de cáncer cercano a este sitio.

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Pathologic High-risk Lesions, Diagnosis and Management

Cited by 11 publications

References 25 publications

Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?

Atypical Ductal Hyperplasia after Vacuum-Assisted Breast Biopsy: Can We Reduce the Upgrade to Breast Cancer to an Acceptable Rate?

Molecular fingerprint of precancerous lesions in breast atypical hyperplasia

Cáncer de mama cercano a cicatriz radial

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