Management of high-risk breast lesions
| High-risk breast lesion | Rate of upgrade to invasive breast cancer | Management after core needle biopsy | Use of risk-reducing endocrine therapy |
|---|---|---|---|
| Atypical ductal hyperplasia | 10% to > 30%14,15 | Observation if radiologic and pathologic findings are concordant or after excisional biopsy | Yes |
| Atypical lobular hyperplasia | 0% to 67%17 | Observation if radiologic and pathologic findings are concordant or consider an excisional biopsy | Yes |
| Flat epithelial atypia | 0% to 21%16 | Observation if radiologic and pathologic findings are concordant or consider an excisional biopsy | Assess breast cancer risk factors and use available risk-assessment calculators (BCRAT or IBIS) Yes, if there is elevated risk |
BCRAT = Breast Cancer Risk Assessment Tool; IBIS = International Breast Cancer Intervention Study