Abstract
The aim of assessment of screen-detected lesions is to achieve a definitive diagnosis and thereby avoid diagnostic surgery.
Highlights
Neoplastic tissue contains elevated levels of choline-containing metabolites [1,2]
We examined the extent to which the lower mammographic sensitivity found in hormone replacement therapy (HRT) users could be explained by any association of HRT use with higher density and more difficult to detect cancers
The results suggest that applying compression does not ensure breast thickness reduction and observing physical changes does not guarantee that breast thickness has been minimised
Summary
Neoplastic tissue contains elevated levels of choline-containing metabolites (tCho) [1,2]. The presence of spiculation arising from a mass detected at mammography makes malignancy a probable diagnosis This is confirmed by this review of the first 8 years of screening in East Sussex where only 3.6% of masses with spiculation were benign at excision (24 out of 668), compared with 33.3% of masses without spiculation (102 out of 306). When breast core biopsy reveals lobular neoplasia (lobular carcinoma in situ [LCIS] or atypical lobular hyperplasia [ALH]) a management dilemma follows, as uncertainty regarding the significance of LCIS/ALH exists. Is this an indicator of increased risk of breast cancer or should it be considered a marker for more serious local pathology? Is this an indicator of increased risk of breast cancer or should it be considered a marker for more serious local pathology? Should surgical excision be undertaken in these cases?
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