Current Management of High-Risk Breast Lesions

AbstractPurpose of reviewThe purpose of this review is to describe recent updates in the management of high-risk breast lesions. We review the various high-risk breast lesions and evaluate the collective literature regarding the rates of upgrade to invasive cancer or ductal carcinoma in situ with excisional biopsy as well as the increased risk for future breast cancer development that a diagnosis of a high-risk breast lesion may portend. For those lesions associated with an increased risk of breast cancer, we discuss the appropriate surveillance regimens as well as risk reduction opportunities available to patients.Recent findingsRecent studies may suggest a role for close imaging observation in certain clinical settings when a benign intraductal papilloma or flat epithelial atypia is identified by core needle breast biopsy. Ongoing prospective clinical trials should reveal valuable data to help answer this question.SummaryClinical management of high-risk breast lesions identified and determined to be concordant after image-guided core needle biopsy varies and prospective data are needed to better guide management decisions. High-risk breast lesions require close radiologic-pathologic correlation when diagnosed by image-guided breast core needle biopsy. Excisional biopsy can exclude a higher-grade lesion such as DCIS or invasive cancer; however, in certain cases, close observation with follow-up may be appropriate. Additionally, women who have certain high-risk lesions such a...
Source: Current Radiology Reports - Category: Radiology Source Type: research

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Source: BMJ Comments - Category: General Medicine Source Type: forums
Conclusion: TRAM flap reconstruction after mastectomy is an appropriate way to improve the patient’s postoperative physical appearance. The results of this study indicated that TRAM flap reconstruction after mastectomy is safe, with an acceptably low number of complications and can be performed by a single surgeon in conjunction with a mastectomy procedure; furthermore, the majority of patients were satisfied with their reconstructed breast. PMID: 29927563 [PubMed - in process]
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Conclusion: Most of the results of lower abdominal ultrasound in the patients sent for whole abdominal ultrasound were negative, and the majority of the positive findings were benign conditions requiring no further management. More positive results, especially findings suggestive or suspicious of cancers, were seen in cases with positive clinical data. Routine use of whole abdominal ultrasound does not appear to be very helpful, especially in patients who have no symptoms in the lower abdomen. PMID: 29927560 [PubMed - in process]
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Conclusion: The immunohistochemistry panel of CK7, CK20 and TTF-1 in the Rajavithi Hospital database is useful as a guide in locating the origin of clinically unknown primary cases of metastatic cervical lymph nodes. PMID: 29927559 [PubMed - in process]
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Authors: Lokejareonlarb S, Chamalerk P Abstract Background: Latissimus Dorsi flap (LD flap) has been used since the eighteenth century to cover large chest wall defects after total mastectomy and is thought to be superior to split thickness skin graft in terms of both cosmetic results and functionality. The outcomes and complications resulting from the use of LD flap reconstruction for large breast cancer are not well documented in Thailand. Objective: To describe a technique using the Latissimus Dorsi musculocutaneous flap for breast reconstruction. The outcomes, complications and length of stay after operatio...
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Conclusion: Women with OC are significantly more associated with hypercoagulable state than those with benign gynecologic diseases. Plasma fibrinogen level was the significant predictive factor for OC, and only 1 post-operative VTE event occurred. PMID: 29927556 [PubMed - in process]
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Conclusion: The results showed that the prevalence of chronic HBV infection in SLE patients was lower than in the general population. Even though they had received high doses of corticosteroid and immunosuppressive agents, no HBV reactivation was found in these SLE patients with chronic HBV infection. PMID: 29927230 [PubMed - in process]
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Mixed ductal-lobular carcinomas (MDL) display both ductal and lobular morphology, and are a clear example of intratumour morphological heterogeneity. The evolution of MDL carcinomas is not well understood. There is a paucity of data surrounding the genetic origin of the different morphological compartments and it remains to be seen whether the coincident presentation of these distinct morphological entities represents two independent tumours that have collided (so called 'collision tumours'), or whether they arise from a common clone. We propose that clonal progression during the evolution of these tumours is associated wi...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
Mixed ductal-lobular carcinomas (MDL) display both ductal and lobular morphology, and are a clear example of intratumour morphological heterogeneity. The evolution of MDL carcinomas is not well understood. There is a paucity of data surrounding the genetic origin of the different morphological compartments and it remains to be seen whether the coincident presentation of these distinct morphological entities represents two independent tumours that have collided (so called 'collision tumours'), or whether they arise from a common clone. We propose that clonal progression during the evolution of these tumours is associated wi...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
CONCLUSION: Primary cultures of DCIS derived directly from patient tissues may serve as in vitro models for the study of DCIS.Citation Format: McAuliffe PF, Brown DD, Oesterreich S, Lee AV, Johnson RR, McGuire KP, Davidson NE, Brufsky AM, Dabbs DJ. Developing in vitro models of ductal carcinoma in situ from primary tissue. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-08-02.
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
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