Year: 2025
Type: article
Abstract: To outline the management for high-risk lesions identified on image-guided breast biopsy.The ASBrS is in the process of developing more systematic and comprehensive guidance around the management of these lesions, with an anticipated release in 2025. Associated ASBrS Guidelines or Quality Measures• Image-Guided Percutaneous Biopsy of Palpable and Nonpalpable Breast Lesions • Performance and Practice Guidelines for Stereotactic Breast Procedures • Concordance Assessment Following Image-Guided Breast Biopsy Methods Literature review evaluating the management of various benign and high-risk lesions (including atypical ductal hyperplasia, lobular neoplasia, papillary lesions, radial scar and complex sclerosing lesions, fibroepithelial lesions, mucocele-like lesions, spindle cell lesions, and pseudoangiomatous stromal hyperplasia) identified on image-guided breast biopsies.This is not a complete systematic review but a review of the modern literature on this subject.The ASBrS Research Committee developed a consensus document which the ASBrS Board of Directors reviewed and approved. ASBrS Recommendations for High-Risk Lesions identified on Percutaneous Breast BiopsyThe following general considerations of selective versus routine excision can be applied to any high-risk lesion:• Estimates of the risk of upgrade to malignancy are improved with multi-disciplinary input from breast radiologist, breast surgeon, and breast pathologist.Lesion Recommendationª Exceptions / Notes ADH Surgical excision Patients who meet low-risk criteria can be considered for observation (see summary of data below) Classic LCIS / ALH No excision Observation with clinical and imaging follow-up b,c Excision if other benign lesion with potential for upstaging is present or if not incidental (see summary of data below) Non-classic LCIS (pleomorphic and florid) Surgical excision to negative margins d Similar for necrosis and other nonclassical lesions CCL without atypia No excision Return to screening
Source: Indian Journal of Breast Imaging
Author: Manisha Bahl
Institutions: Harvard University, Massachusetts General Hospital
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4411215440