Our Summary

This research looked at how often high-risk lesions (HRLs) in the breast, diagnosed by MRI-guided biopsy, become malignant. This study looked at data from August 2011 to August 2020. Only lesions that were removed or monitored for at least two years were included.

The study found that out of 72 lesions in 65 patients, 11.1% turned malignant. The rate varied depending on the type of HRL. For example, 16.7% of lesions identified as Atypical Ductal Hyperplasia (ADH) and 40% of a certain type of Lobular Carcinoma In Situ (LCIS) turned malignant. However, none of the lesions identified as Atypical Lobular Hyperplasia (ALH), papilloma, or radial scar/complex sclerosing lesion turned malignant.

The study also found that lesions were more likely to become malignant if they showed specific characteristics on the MRI.

The researchers concluded that ADH and LCIS should be surgically removed due to their high rates of becoming malignant. They also advised that lesions showing certain characteristics on the MRI should be treated with caution, as they were more likely to become malignant.

FAQs

  1. What percentage of high-risk lesions (HRLs) in the breast turned malignant according to this study?
  2. Which types of lesions were found to be more likely to turn malignant in this research?
  3. What were the study’s recommendations for handling lesions identified as Atypical Ductal Hyperplasia (ADH) and Lobular Carcinoma In Situ (LCIS)?

Doctor’s Tip

A doctor may advise a patient undergoing a breast biopsy to ask questions about the type of lesion found and its likelihood of becoming malignant. They may also recommend close monitoring or surgical removal depending on the type of lesion and its characteristics. It is important for the patient to follow up regularly with their healthcare provider and discuss any concerns or changes in their breast health.

Suitable For

Patients who are typically recommended for breast biopsy include those with high-risk lesions identified through imaging studies like MRI, those with a family history of breast cancer, those with abnormal findings on a mammogram or ultrasound, and those with symptoms such as a lump in the breast or nipple discharge. Additionally, patients with a history of breast cancer or other risk factors for developing breast cancer may also be recommended for a breast biopsy.

Timeline

Before the breast biopsy:

  1. Patient undergoes a screening mammogram which shows a suspicious lesion.
  2. Patient may undergo additional imaging tests such as a diagnostic mammogram or breast ultrasound.
  3. If the lesion is still concerning, the patient may be recommended for a breast biopsy.
  4. Patient schedules an appointment for a breast biopsy.

After the breast biopsy:

  1. Patient undergoes the breast biopsy procedure, which can be done using various techniques such as ultrasound-guided, MRI-guided, or stereotactic biopsy.
  2. Patient may experience some discomfort or pain after the biopsy procedure.
  3. A pathologist examines the biopsy sample to determine if the lesion is benign or malignant.
  4. Patient receives the biopsy results from their healthcare provider.
  5. Depending on the biopsy results, further treatment or monitoring may be recommended.

What to Ask Your Doctor

Some questions a patient should ask their doctor about breast biopsy based on this research include:

  1. What type of high-risk lesion was found in my breast biopsy?
  2. What are the chances that my high-risk lesion could turn malignant based on the type identified in the biopsy?
  3. Did the biopsy show any specific characteristics on the MRI that indicate a higher likelihood of the lesion becoming malignant?
  4. Do you recommend surgical removal of the high-risk lesion based on its type and characteristics?
  5. Are there any alternative treatment options or monitoring strategies for managing the high-risk lesion?
  6. What are the potential risks and benefits of surgical removal versus monitoring the high-risk lesion?
  7. How often will I need follow-up appointments or imaging tests to monitor the high-risk lesion for changes?
  8. Are there any lifestyle changes or preventive measures I should take to reduce my risk of developing breast cancer in the future, especially considering the presence of a high-risk lesion?
  9. Are there any additional tests or procedures that may be recommended based on the results of the breast biopsy?
  10. Can you provide more information about the specific findings of my biopsy and how they compare to the results of this research study?

Reference

Authors: Cha E, Ambinder EB, Oluyemi ET, Mullen LA, Panigrahi B, Rossi J, Di Carlo PA, Myers KS. Journal: Breast Cancer Res Treat. 2022 Dec;196(3):517-525. doi: 10.1007/s10549-022-06761-7. Epub 2022 Oct 15. PMID: 36242709