Assessment and management of B3 breast lesions with atypia: a focused review

Abstract

Breast lesions with atypia are a spectra of diseases that confer increased risk of breast cancer because of an increased probability of finding concomitant cancer after excision, or evolution toward in situ or invasive cancer over the long term. The widespread use of radiologic tools and core needle breast biopsies, in recent years, has led to an increase in the diagnosis of these atypical breast lesions. Concurrent with this has been an improvement in the classification and pathogenesis of these lesions. Current evidence suggests that the recognition and treatment of patients with atypical histology after biopsy and surgical excision requires a multidisciplinary approach to decrease the overdiagnosis and overtreatment risks. This focused review investigates the controversy and current management of atypical ductal hyperplasia, lobular neoplasia, flat epithelial atypia, and intraductal papilloma with atypia along with the risk-reducing strategies.

摘要

非典型性乳腺病变是一系列增加乳腺癌风险的疾病, 因其在切除后发现伴生癌的可能性增加, 或在长期内向原位癌或侵袭性癌发展。近年来, 广泛应用的放射工具和细针乳腺活检使得这些非典型乳腺病变的诊断增加。与此同时, 这些病变的分类和发病机制也得到了提高。目前的证据表明, 组织活检和手术切除后非典型组织学的识别和治疗需要多学科合作来降低过度诊断和过度治疗的风险。本文重点探讨了导管上皮非典型增生、小叶瘤变、扁平上皮异型性、导管内非典型乳头状瘤的争议及目前的处理方法, 并探讨了降低风险的策略。

Keywords:

• B3 breast lesions
• atypia
• uncertain malignant potential
• breast cancer
• breast surgery

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Source of funding

Nil.