Evidence map›Paper›PMID 41004069›Full record

ArticleBreast cancer research and treatment2025

Long-term follow-up confirms patients with high-risk breast lesions can be successfully managed at a multidisciplinary conferences.

Wei Yang, Ashlyn Alongi, Zhongliang Ma, Toncred M Styblo, Cletus A Arciero, Clara Farley, Christopher Ho, Ruth M O'Regan, Michael A Cohen, Neeti Bagadiya and 1 more

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Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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5 · Who and what money

Authors and funding

11 authors.

Wei Yang *Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
Ashlyn Alongi *Department of Surgery, Emory University, Atlanta, USA.
Zhongliang MaBreast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, China.
Toncred M StybloDepartment of Surgery, Emory University, Atlanta, USA.
Cletus A ArcieroDepartment of Surgery, Emory University, Atlanta, USA.
Clara FarleyDepartment of Surgery, Emory University, Atlanta, USA.
Christopher HoDepartment of Radiology and Imaging Sciences, Emory University, Atlanta, USA.
Ruth M O'ReganDepartment of Medicine, University of Rochester, Rochester, USA.
Michael A CohenDepartment of Radiology and Imaging Sciences, Emory University, Atlanta, USA.
Neeti BagadiyaDepartment of Radiology and Imaging Sciences, Emory University, Atlanta, USA.
Xiaoxian LiDepartment of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA. xli40@emory.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of high-risk breast lesions is controversial. There is a lack of long-term follow-up studies to evaluate clinical management decisions.

methodsWe included 267 consecutive high-risk breast lesions with pathology-radiology concordance that were prospectively recommended for surgery or follow-up at a multidisciplinary conference. The 267 lesions included 149 papillomas and 118 other high-risk lesions. The 149 papillomas included 119 benign papillomas, 17 atypical papillomas, 6 papillomas with adjacent atypical ductal hyperplasia (ADH), 7 papillomas with adjacent atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS). The 118 high-risk lesions included 43 ADH, 36 radial scar (RS), 23 ALH, 13 LCIS, 2 flat epithelial atypia (FEA), and 1 mucocele-like lesion (ML). The patients were recommended for surgery or follow-up using established guidelines.

results90 (60.4%) patients with papillomas, who did not undergo immediate excision and were followed, had a median follow-up time of 61.6 months; 70 patients had a follow-up time > 2 years (25.1-103.4 months). Two patients (2.1%) with benign papilloma had history of breast cancer and developed carcinoma in 62.7 at the lumpectomy site and 40.8 months at the biopsy site which showed 2 mm benign papilloma; both papillomas were sufficiently sampled, and we believe the recommendation of follow-up to both patients was appropriate. 65 (55.1%) patients with other high-risk lesions, who did not undergo excision and were followed, had a median follow-up time of 64.1 months; 50 patients had a follow-up time > 2 years (24.2-101.6 months). Four (6.2%) of these 65 patients developed carcinoma during follow-up including 2 patients with ADH who were recommended for surgery but chose for follow-up; 1 patient with ALH developed invasive carcinoma in a different quadrant at 76.6 months; and 1 patient with RS developed invasive carcinoma in the same quadrant at 51.2 months. In the 112 patients who underwent immediate excision, all upgrades (n = 15) occurred in patients who were recommended for surgery. During follow-up of these 112 patients, 2 patients developed carcinoma and both had benign pathology in the excisional specimens.

conclusionsThis long-term follow-up study confirms that a multidisciplinary conference can successfully triage patients with high-risk breast lesions to surgery or follow-up with established guidelines and careful pathology, radiology, and clinical evaluations. Patients with high-risk breast lesions have increased cancer risk and should be followed.

Indexed as

Breast NeoplasmsPapillomaAdultAgedAged, 80 and overDisease ManagementFemaleFollow-Up StudiesHumansMiddle AgedADHALHBreast high-risk lesionsFollow-upLCISMultidisciplinary conferencePapillomaRadial scar

Identifiers

PMID41004069

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