It is well known that certain types of pre-malignant lesions can predispose some women to increased risk of breast cancer. These certain types of pre-malignant lesions are generally classified as high-risk breast lesions. These lesions become invasive cancers in about 15% of patients and hence the management and treatment of these lesions warrant a significant discussion. There are several categories of these lesions, to include atypical hyperplasia of the breast (atypical ductal hyperplasia and atypical lobular hyperplasia); carcinoma in situ (ductal carcinoma in situ and lobular carcinoma in situ); columnar cell pre-malignant lesions; lobular intraepithelial neoplasia (LIN III); radial scar/complex sclerosing lesion; sclerosing adenosis and papillary lesions of the breast. These lesions are morphologically, radiologically, histologically and clinically heterogeneous and early identification can help to prevent progression to invasive cancers. The management of these lesions has been debated internationally for years by experts as to the best treatment modality with surgical excision of the lesion often not considered necessary. It is thus important to evaluate each patient on an individual case-by-case basis. The characteristics of these high-risk breast lesions are further discussed in this chapter.
Part of the book: Breast Imaging