High-Risk Benign Breast Lesions Recommendations Report

Guideline

The objective of this report is to provide recommendations on the management of high-risk benign breast lesions.

Patient Population

Patients presenting with high-risk benign breast lesions, including atypical ductal hyperplasia, mucocele-like lesions, papillary lesions, radial scars/complex sclerosing lesions, atypical lobular hyperplasia, lobular carcinoma in situ, columnar cell change, flat epithelial atypia, fibroepithelial lesions with increased stromal cellularity, spindle cell lesions/mesenchymal lesions, and microglandular adenosis.

Intended Guideline Users

Surgeons, oncologists, primary care providers, radiologists, and pathologists with a special interest in breast cancer.

Research Question(s)

1. Describe the risk of upstaging at excision of high-risk lesions diagnosed by needle biopsy. What are the factors that predict upstaging?
2. Which high-risk benign breast lesions need to be excised versus followed?
   a) For lesions that are not excised and are concordant, what is the appropriate interval and length of follow-up?