Breast Cancer Risk and Follow-up Recommendations for Young Women Diagnosed with Atypical Hyperplasia and Lobular Carcinoma In Situ (LCIS)

Maureen P. McEvoy, Suzanne B. Coopey, Emanuele Mazzola, Julliette Buckley, Ahmet Belli, Fernanda Polubriaginof, Andrea L. Merrill, Rong Tang, Judy E. Garber, Barbara L. Smith, Michele A. Gadd, Michelle C. Specht, Anthony J. Guidi, Constance A. Roche, Keven S. Hughes

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: The risk of breast cancer in young women diagnosed with atypical hyperplasia and (LCIS) is not well defined. The objectives were to evaluate outcomes and to help determine guidelines for follow-up in this population. Methods: A retrospective review of women under age 35 diagnosed with ADH, ALH, LCIS, and severe ADH from 1987 to 2010 was performed. Patient characteristics, pathology and follow-up were determined from chart review. Results: We identified 58 young women with atypical breast lesions. Median age at diagnosis was 31 years (range 19–34). 34 patients had ADH, 11 had ALH, 8 had LCIS, and 5 had severe ADH. 7 (12%) patients developed breast cancer. The median follow-up was 86 months (range 1–298). Median time to cancer diagnosis was 90 months (range 37–231). 4 cancers were on the same side, 3 were contralateral. 4 were IDC, 1 was ILC, and 2 were DCIS. Cancer was detected by screening mammogram in 4 patients, 2 by clinical exam, and 1 unknown. In the entire cohort, 26 (45%) patients had screening mammograms as part of their follow up, 12 patients had only clinical follow up, and 20 had no additional follow up. 13 patients required subsequent biopsies. Conclusion: Young women with atypical breast lesions are at a markedly increased risk for developing breast cancer and should be followed closely. Based on our findings, we recommend close clinical follow-up, MRI starting at age 25 through age 29, and screening mammograms for those over 30 in this high-risk group of patients.

Original languageEnglish (US)
Pages (from-to)3346-3349
Number of pages4
JournalAnnals of Surgical Oncology
Volume22
Issue number10
DOIs
StatePublished - Oct 29 2015
Externally publishedYes

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Hyperplasia
Breast Neoplasms
Breast
Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Breast Carcinoma In Situ
Guidelines
Pathology
Biopsy
Population

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Breast Cancer Risk and Follow-up Recommendations for Young Women Diagnosed with Atypical Hyperplasia and Lobular Carcinoma In Situ (LCIS). / McEvoy, Maureen P.; Coopey, Suzanne B.; Mazzola, Emanuele; Buckley, Julliette; Belli, Ahmet; Polubriaginof, Fernanda; Merrill, Andrea L.; Tang, Rong; Garber, Judy E.; Smith, Barbara L.; Gadd, Michele A.; Specht, Michelle C.; Guidi, Anthony J.; Roche, Constance A.; Hughes, Keven S.

In: Annals of Surgical Oncology, Vol. 22, No. 10, 29.10.2015, p. 3346-3349.

Research output: Contribution to journalArticle

McEvoy, MP, Coopey, SB, Mazzola, E, Buckley, J, Belli, A, Polubriaginof, F, Merrill, AL, Tang, R, Garber, JE, Smith, BL, Gadd, MA, Specht, MC, Guidi, AJ, Roche, CA & Hughes, KS 2015, 'Breast Cancer Risk and Follow-up Recommendations for Young Women Diagnosed with Atypical Hyperplasia and Lobular Carcinoma In Situ (LCIS)', Annals of Surgical Oncology, vol. 22, no. 10, pp. 3346-3349. https://doi.org/10.1245/s10434-015-4747-1
McEvoy, Maureen P. ; Coopey, Suzanne B. ; Mazzola, Emanuele ; Buckley, Julliette ; Belli, Ahmet ; Polubriaginof, Fernanda ; Merrill, Andrea L. ; Tang, Rong ; Garber, Judy E. ; Smith, Barbara L. ; Gadd, Michele A. ; Specht, Michelle C. ; Guidi, Anthony J. ; Roche, Constance A. ; Hughes, Keven S. / Breast Cancer Risk and Follow-up Recommendations for Young Women Diagnosed with Atypical Hyperplasia and Lobular Carcinoma In Situ (LCIS). In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 10. pp. 3346-3349.
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title = "Breast Cancer Risk and Follow-up Recommendations for Young Women Diagnosed with Atypical Hyperplasia and Lobular Carcinoma In Situ (LCIS)",
abstract = "Background: The risk of breast cancer in young women diagnosed with atypical hyperplasia and (LCIS) is not well defined. The objectives were to evaluate outcomes and to help determine guidelines for follow-up in this population. Methods: A retrospective review of women under age 35 diagnosed with ADH, ALH, LCIS, and severe ADH from 1987 to 2010 was performed. Patient characteristics, pathology and follow-up were determined from chart review. Results: We identified 58 young women with atypical breast lesions. Median age at diagnosis was 31 years (range 19–34). 34 patients had ADH, 11 had ALH, 8 had LCIS, and 5 had severe ADH. 7 (12{\%}) patients developed breast cancer. The median follow-up was 86 months (range 1–298). Median time to cancer diagnosis was 90 months (range 37–231). 4 cancers were on the same side, 3 were contralateral. 4 were IDC, 1 was ILC, and 2 were DCIS. Cancer was detected by screening mammogram in 4 patients, 2 by clinical exam, and 1 unknown. In the entire cohort, 26 (45{\%}) patients had screening mammograms as part of their follow up, 12 patients had only clinical follow up, and 20 had no additional follow up. 13 patients required subsequent biopsies. Conclusion: Young women with atypical breast lesions are at a markedly increased risk for developing breast cancer and should be followed closely. Based on our findings, we recommend close clinical follow-up, MRI starting at age 25 through age 29, and screening mammograms for those over 30 in this high-risk group of patients.",
author = "McEvoy, {Maureen P.} and Coopey, {Suzanne B.} and Emanuele Mazzola and Julliette Buckley and Ahmet Belli and Fernanda Polubriaginof and Merrill, {Andrea L.} and Rong Tang and Garber, {Judy E.} and Smith, {Barbara L.} and Gadd, {Michele A.} and Specht, {Michelle C.} and Guidi, {Anthony J.} and Roche, {Constance A.} and Hughes, {Keven S.}",
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T1 - Breast Cancer Risk and Follow-up Recommendations for Young Women Diagnosed with Atypical Hyperplasia and Lobular Carcinoma In Situ (LCIS)

AU - McEvoy, Maureen P.

AU - Coopey, Suzanne B.

AU - Mazzola, Emanuele

AU - Buckley, Julliette

AU - Belli, Ahmet

AU - Polubriaginof, Fernanda

AU - Merrill, Andrea L.

AU - Tang, Rong

AU - Garber, Judy E.

AU - Smith, Barbara L.

AU - Gadd, Michele A.

AU - Specht, Michelle C.

AU - Guidi, Anthony J.

AU - Roche, Constance A.

AU - Hughes, Keven S.

PY - 2015/10/29

Y1 - 2015/10/29

N2 - Background: The risk of breast cancer in young women diagnosed with atypical hyperplasia and (LCIS) is not well defined. The objectives were to evaluate outcomes and to help determine guidelines for follow-up in this population. Methods: A retrospective review of women under age 35 diagnosed with ADH, ALH, LCIS, and severe ADH from 1987 to 2010 was performed. Patient characteristics, pathology and follow-up were determined from chart review. Results: We identified 58 young women with atypical breast lesions. Median age at diagnosis was 31 years (range 19–34). 34 patients had ADH, 11 had ALH, 8 had LCIS, and 5 had severe ADH. 7 (12%) patients developed breast cancer. The median follow-up was 86 months (range 1–298). Median time to cancer diagnosis was 90 months (range 37–231). 4 cancers were on the same side, 3 were contralateral. 4 were IDC, 1 was ILC, and 2 were DCIS. Cancer was detected by screening mammogram in 4 patients, 2 by clinical exam, and 1 unknown. In the entire cohort, 26 (45%) patients had screening mammograms as part of their follow up, 12 patients had only clinical follow up, and 20 had no additional follow up. 13 patients required subsequent biopsies. Conclusion: Young women with atypical breast lesions are at a markedly increased risk for developing breast cancer and should be followed closely. Based on our findings, we recommend close clinical follow-up, MRI starting at age 25 through age 29, and screening mammograms for those over 30 in this high-risk group of patients.

AB - Background: The risk of breast cancer in young women diagnosed with atypical hyperplasia and (LCIS) is not well defined. The objectives were to evaluate outcomes and to help determine guidelines for follow-up in this population. Methods: A retrospective review of women under age 35 diagnosed with ADH, ALH, LCIS, and severe ADH from 1987 to 2010 was performed. Patient characteristics, pathology and follow-up were determined from chart review. Results: We identified 58 young women with atypical breast lesions. Median age at diagnosis was 31 years (range 19–34). 34 patients had ADH, 11 had ALH, 8 had LCIS, and 5 had severe ADH. 7 (12%) patients developed breast cancer. The median follow-up was 86 months (range 1–298). Median time to cancer diagnosis was 90 months (range 37–231). 4 cancers were on the same side, 3 were contralateral. 4 were IDC, 1 was ILC, and 2 were DCIS. Cancer was detected by screening mammogram in 4 patients, 2 by clinical exam, and 1 unknown. In the entire cohort, 26 (45%) patients had screening mammograms as part of their follow up, 12 patients had only clinical follow up, and 20 had no additional follow up. 13 patients required subsequent biopsies. Conclusion: Young women with atypical breast lesions are at a markedly increased risk for developing breast cancer and should be followed closely. Based on our findings, we recommend close clinical follow-up, MRI starting at age 25 through age 29, and screening mammograms for those over 30 in this high-risk group of patients.

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