Our Summary

This research paper reviews recent studies about non-cancerous changes in breast tissue that are found during a specific type of biopsy called a core needle biopsy. There isn’t a lot of agreement about how to treat or monitor patients with these changes, which include conditions like atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ. These conditions are often found to become cancerous when a more extensive biopsy is done, but the frequency of this happening varies widely across different studies. The authors emphasize that many studies do not have clear guidelines for when a more extensive biopsy should be done, and don’t always include follow-up with patients who don’t have the more extensive biopsy. The aim of this review is to use the latest research to develop an evidence-based approach to managing these non-cancerous breast changes. It highlights data that supports a growing consensus on which conditions do not need a more extensive biopsy. The review also discusses how these non-cancerous changes are managed when they are found during a biopsy guided by magnetic resonance imaging.

FAQs

  1. What are some common non-malignant lesions found in percutaneous core needle biopsies?
  2. What is the current approach to managing non-malignant lesions of the breast diagnosed on CNB?
  3. Why is there a lack of consensus in the management of non-malignant breast lesions diagnosed on CNB?

Doctor’s Tip

A doctor might tell a patient undergoing a breast biopsy that while the results may show non-malignant findings such as atypical hyperplasia or other benign lesions, it is important to follow up with regular clinical and radiological examinations to monitor for any changes. Depending on the specific findings, further surgical biopsy may be recommended or continued observation may be appropriate. It is important to discuss the results and recommended next steps with your doctor to ensure the best course of action for your individual situation.

Suitable For

Patients who are typically recommended breast biopsy include those with suspicious or concerning findings on a mammogram or ultrasound, such as a suspicious mass, microcalcifications, or an area of abnormal tissue. Additionally, patients with a family history of breast cancer, a personal history of breast cancer, or certain genetic mutations that increase the risk of breast cancer may also be recommended for a breast biopsy. Other factors that may lead to a recommendation for biopsy include changes in breast tissue detected during a physical exam, such as a lump or thickening, as well as symptoms such as nipple discharge or skin changes. Ultimately, the decision to recommend a breast biopsy is based on a combination of clinical factors, imaging findings, and patient risk factors.

Timeline

Before breast biopsy:

  1. Patient presents with a breast lump or abnormal mammogram
  2. Patient undergoes physical examination and imaging studies (such as mammogram or ultrasound)
  3. Decision is made to perform a breast biopsy
  4. Patient receives information about the procedure and gives consent
  5. Biopsy is performed, typically using a core needle biopsy technique

After breast biopsy:

  1. Patient may experience some discomfort or pain at the biopsy site
  2. Biopsy sample is sent to a pathology lab for analysis
  3. Pathologist examines the sample and provides a diagnosis
  4. Patient receives the biopsy results and discusses next steps with their healthcare provider
  5. Depending on the results, patient may be recommended for further tests, surgery, or follow-up monitoring
  6. Treatment plan is developed based on the biopsy findings, which may include surgery, medication, or continued surveillance

It is important for patients to follow up with their healthcare provider and adhere to the recommended treatment plan to ensure optimal outcomes.

What to Ask Your Doctor

  1. What specific type of non-malignant lesion was found in the breast biopsy?
  2. What is the likelihood of this non-malignant lesion developing into cancer in the future?
  3. What are the recommended next steps for further evaluation or treatment?
  4. Are there any risk factors or lifestyle changes that can help prevent the development of cancer in the future?
  5. What is the likelihood of needing additional biopsies or surgical procedures in the future?
  6. Will this non-malignant lesion impact my future breast cancer screening recommendations?
  7. Are there any specific symptoms or changes I should watch for that may indicate a progression of the non-malignant lesion?
  8. How often should I follow up with my healthcare provider for monitoring of this non-malignant lesion?
  9. Are there any potential complications or side effects associated with the recommended treatment or monitoring plan?
  10. Are there any additional resources or support groups available for individuals with non-malignant breast lesions?

Reference

Authors: Calhoun BC, Collins LC. Journal: Histopathology. 2016 Jan;68(1):138-51. doi: 10.1111/his.12852. PMID: 26768035