Breast lesions with atypia in percutaneous biopsies, managed with surgery in the last 10 years
| Autor: | Augusto León, Francisco Domínguez, Gregorio Maturana, César Sánchez, Cristóbal Maiz, Mitzy Carrillo, David Oddó, Dravna Razmilic, Diego Romero, Mauricio Camus, María Elena Navarro, Alejandra Villarroel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Cancer Research
medicine.medical_specialty Percutaneous medicine.medical_treatment Lobular carcinoma Case Report atypical ductal hyperplasia atypical lobular hyperplasia Lesion 03 medical and health sciences 0302 clinical medicine Atypia Medicine Clinical significance 030212 general & internal medicine skin and connective tissue diseases lobular carcinoma in situ business.industry Retrospective cohort study Ductal carcinoma medicine.disease Surgery Radiation therapy Oncology flat epithelial atypia 030220 oncology & carcinogenesis breast lesions with atypia medicine.symptom business |
| Zdroj: | ecancermedicalscience |
| ISSN: | 1754-6605 |
| Popis: | Introduction The optimal management of breast lesions with atypia (BLA), detected in percutaneous biopsies after screening mammograms, is a controversial issue. The aim of this paper is to compare histological diagnosis by percutaneous biopsy with the results of the surgical biopsy of these lesions and to analyse the changes to clinical approach this would imply. Method A retrospective study was carried out on patients operated on between June 2007 and June 2017 with a diagnosis of BLA. One hundred and forty-seven patients were identified with a pre-operative diagnosis of flat epithelial atypia (FEA), atypical ductal hyperplasia (ADH), atypical lobular hyperplasia, lobular carcinoma in situ and other atypia. Results The average age at diagnosis of BLAs was 52 ± 9.4 years. Radiologically, the lesions presented as microcalcifications in 79%, nodules in 15.6% and other lesions 5.4%. 73.5% of these were biopsied by means of digital stereotaxis. All of the patients analysed underwent a partial mastectomy. Changes in a biologically high-risk lesion were observed in 26.5% of the surgical specimens, of which 75.5% corresponded with ADH and FEA. In the percutaneous biopsies consistent with ADH (40.1%), ductal carcinoma was discovered in 6.8% (5.1% in situ and 1.7% invasive), which implied specific, multi-disciplinary management. Of the FEAs, 84.8% required a second treatment (surgery and/or hormone therapy ± radiotherapy, depending on whether it concerned FEA 59.6%, ADH 21.2% or ductal carcinoma in situ 3.8%). Conclusion These data show the clinical relevance in the diagnosis of ADH and FEA in percutaneous biopsies. For the diagnosis of FEA in particular, the associated risk of biologically high-risk lesions and ductal carcinoma is made evident. |
| Databáze: | OpenAIRE |
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