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How Do We Approach Benign Proliferative Lesions?

  • Breast Cancer (B Overmoyer, Section Editor)
  • Published:
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Abstract

Purpose of Review

The aim of this review is to summarize recently published literature addressing atypical ductal hyperplasia (ADH), lobular neoplasia (atypical lobular hyperplasia [ALH] and classic lobular carcinoma in situ [C-LCIS]), non-classic lobular carcinoma in situ (NC-LCIS), papillary lesions, and flat epithelial atypia (FEA).

Recent Findings

While ADH, ALN, and C-LCIS are well-established markers of an increased risk of future breast cancers, the risk implications are less clear for papillary lesions and FEA. NC-LCIS is the least well-characterized lesion, with scant published literature on its natural history and surgical management when encountered on needle biopsy.

Summary

Recent data suggest that lobular neoplasia on core biopsy of a BI-RADS ≤ 4 concordant lesion does not require an excision, while ADH, atypical papillomas, and NC-LCIS should be excised. Evidence on FEA and papillomas without atypia suggests a low risk of upgrade on excision, and prospective studies on the upgrade of these lesions are ongoing.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Department of Surgery, Brigham and Women’s Hospital, 75 Francis St., Boston, MA, 02115, USA

    Faina Nakhlis

  2. Surgical Oncology, Breast Oncology Program, Dana-Farber/Brigham and Women’s Cancer Center, 450 Brookline Ave., Boston, MA, 02115, USA

    Faina Nakhlis

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Nakhlis, F. How Do We Approach Benign Proliferative Lesions?. Curr Oncol Rep 20, 34 (2018). https://doi.org/10.1007/s11912-018-0682-1

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