Abstract
Lesions of uncertain malignant potential include radial scars, papillary lesions and mucoceles. Lobular neoplasia and atypical ductal hyperplasia (ADH) are often associated with such abnormalities and present similar problems. Columnar cell atypia and apocrine atypia, once their natural history has been elucidated, may join this group of lesions. The management of lesions of uncertain malignant potential has become a more common and complex problem in recent years. The introduction of first core biopsy and then vacuum-assisted biopsy devices has led to an increase in the nonoperative diagnosis of such lesions. These lesions may be incidental findings that do not represent the clinical or radiological abnormality. In the past, such lesions were managed by surgical excision (radial scar, papillary lesion and ADH) or by mammographic follow-up (lobular neoplasia). It is now recognised that the upgrade rates to ductal carcinoma in situ or invasive cancer vary in proportion to the degree of cellular atypia present and by the amount of tissue removed at percutaneous biopsy. Vacuum biopsy excision is also an option for some of these lesions. In this session we shall discuss a number of such cases to highlight the difficulties and dilemmas found when managing these lesions.
Highlights
Axillary lymph node dissection has been standard practice for staging invasive breast cancer
Best estimates for where to credit this dramatic drop in death rate place approximately 50% of the credit with improved adjuvant chemotherapy and 50% with mammography
Full field digital mammography (FFDM) had a higher detection rate for ductal carcinoma in situ (DCIS) but no difference was observed for invasive tumours
Summary
Axillary lymph node dissection has been standard practice for staging invasive breast cancer. Aim To assess the feasibility of surgeons performing breast US in symptomatic breast clinics either as an adjunct to triple assessment or on their own for diagnostic and therapeutic purposes. The performance of individual units is monitored to ensure all women have access to an excellent service Aim This project aims to demonstrate how the Liverpool Breast Unit addressed failure to meet the national quality standard for the benign. Method A retrospective review of the records of patients who had undergone benign biopsy (2001–2002) was conducted to establish reasons for surgical referral and suggest corrective measures to enable the unit to meet the standard in the future. Columnar cell change (CCC) is diagnosed on core biopsies performed for indeterminate microcalcification. Method Mammograms of 33 cases with established CCC on core biopsy were reviewed and the radiological features, follow-up imaging and surgical excision histology (if performed) were collated. The results were completed when all units were undergoing assimilation onto the new banding procedures
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