High-Risk Lesion Management
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY.
Seminars in Ultrasound, CT, and MR
|February 15, 2023
Summary
Management of high-risk breast lesions is evolving. While surgical excision was standard, newer approaches like vacuum-assisted excision or surveillance may suffice for certain lesions, reducing unnecessary surgeries.
Area of Science:
- Breast imaging and pathology
- Oncology
- Surgical management
Background:
- High-risk lesions and lesions of uncertain malignant potential are common findings in image-guided breast biopsies.
- These lesions carry a risk of underlying malignancy and are associated with an increased lifetime breast cancer risk.
Purpose of the Study:
- To review and describe management recommendations for frequent high-risk breast lesions.
- To provide guidance based on recent literature, considering evolving treatment strategies.
Main Methods:
- Literature review of recent studies on high-risk breast lesions.
- Analysis of management strategies including surgical excision, vacuum-assisted excision, and surveillance.
- Focus on frequent lesion types.
Main Results:
- Traditionally, surgical excision was recommended for all high-risk lesions.
- Recent evidence suggests vacuum-assisted excision or surveillance may be appropriate for select lesions.
- Management protocols vary across institutions.
Conclusions:
- The management of high-risk breast lesions is shifting from universal surgical excision.
- Personalized approaches considering lesion type and patient factors are increasingly important.
- Evidence supports less invasive options for certain high-risk findings.
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