Rethinking Routine Surgical Excision for all Radial Sclerosing Lesions of the Breast.

Autor: Patel M; University of Kansas Medical Center, Kansas City, Kansas., Aripoli A; Division of Breast Imaging, Department of Radiology, The University of Kansas Health System, Kansas City, Kansas., Chollet-Hinton L; Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas; The University of Kansas Cancer Center, Kansas City, Kansas., Larson KE; Division of Breast Surgical Oncology, Department of Surgery, The University of Kansas Health System, Kansas City, Kansas., Balanoff CR; Division of Breast Surgical Oncology, Department of Surgery, The University of Kansas Health System, Kansas City, Kansas., Kilgore LJ; Division of Breast Surgical Oncology, Department of Surgery, The University of Kansas Health System, Kansas City, Kansas., Amin AL; Division of Breast Surgical Oncology, Department of Surgery, The University of Kansas Health System, Kansas City, Kansas. Electronic address: Amanda.Amin@UHhospitals.org.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2022 Nov; Vol. 279, pp. 611-618. Date of Electronic Publication: 2022 Aug 01.
DOI: 10.1016/j.jss.2022.06.048
Abstrakt: Introduction: The need for routine surgical excision of a radial sclerosing lesions (RSL) of the breast identified on percutaneous biopsy remains controversial, as contemporary upgrade rates are lower than historically cited.
Materials and Methods: A prospectively-maintained database of high-risk breast biopsies undergoing multidisciplinary review at a single institution was queried to identify cases of RSL from 2/2015 to 11/2020. Demographic, radiologic, and pathologic variables were summarized using frequencies and analyzed in association with RSL excision status using mixed-effects logistic regression or Fisher's exact tests.
Results: 217 RSL were identified, diagnosed at a mean age of 57 y. The median imaging size was 1.3 cm and the majority had estimated >50% of the target removed by core needle biopsy. 32.3% underwent surgical excision of the RSL biopsy site and 2/70 (2.9%) upgraded to ductal carcinoma in situ (DCIS) on final surgical pathology. Upgrade was significantly higher for atypical RSL (P = 0.02). None of the RSL (n = 60) without atypia who had undergone excision were upgraded. For those omitting surgical excision, there was no subsequent breast cancer diagnosis at the RSL site over a mean follow-up of 23 mo.
Conclusions: Surgical excision may be omitted for RSL without atypia as this group has 0% risk of upgrade after multidisciplinary review.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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