High-Risk Lesions at Minimally Invasive Breast Biopsy: Now What?

Purpose The purpose of this section is to provide a detailed review of high-risk lesions and their associated risk of upgrade at surgical excision in order to guide in management and appropriate risk reduction strategies. Recent Findings “High-risk” breast lesions refer to an eclectic group of histologic abnormalities associated with an increased risk of breast cancer. Current data show a vast disparity in upgrade rates upon surgical excision for high-risk lesions, which leads to confusing and often conflicting recommendations. There has been suggestion in the media that breast biopsies lead to “over-diagnosis” and unnecessary breast surgeries. However, the goal of breast imagers is to detect early cancers, and in doing so, the recommendation for surgical excision of the appropriate high-risk lesions is necessary. Summary In managing high-risk lesions we must balance the opportunity to diagnose early, curable breast cancer by recommending surgical excision with prudent and conservative management along with careful radiologic and pathologic correlation.