Lobular Neoplasia, ADH, Radial Scars, and Papillomas…

Thursday, May 19, 2022

9:20 AM – 10:00 AM EDT

Location: Chatham Ballroom

Speaker(s)

KA

Kristen A. Atkins, MD

Director of Anatomic Pathology
University of Virginia School of Medicine
University of Virginia
Michael A. Cohen, MD, FACR, FSBI

Breast imager
Memorial Hermann Woodlands Hospital
Emory University School of Medicine
SPRING, Texas
SH

Samantha L. Heller, MD, PhD, FSBI

Associate Professor, Department of Radiology
NYU School of Medicine
New York, New York
BN

Brandi T. Nicholson, MD, FSBI

Medical Director of Breast Imaging
Augusta Health
Crozet, Virginia

Slides PDF

The lesions discussed in this session are collectively known as "high risk" breast lesions due to their original propensity for upgrade to breast cancer when excised following an image-guided core biopsy diagnosis. Because of this elevated likelihood for upgrade, the traditional standard of care has been to recommend excision in all cases when one of these lesions was encountered on core biopsy. However, with time, improved methods for harvesting biopsy tissue combined with a better understanding of the natural history of these lesions have called into question the necessity to excise all following a core biopsy diagnosis. As with any seismic shift, especially where cancer risk is concerned, controversy regarding management of each high risk lesion abounds. This session will seek to clarify the controversy surrounding each of the lesions and to provide guidelines and recommendations including ways to minimize the possibility of a missed cancer diagnosis when sampling and during rad-path review.

Learning Objectives:

Summarize the histolgic features of each of the high risk lesions especially as they relate to potential diagnostic uncertainty with regard to coexisting but undiagnosed malignancy.
Understand and incorporate lesion sampling practices and rad-path review necessities designed to minimize the risk of a missed cancer diagnosis when a high risk lesion is encountered.
Identify ways to successfully and safely limit the number of excisions required when high risk lesions are encountered on core biopsy