Management of High-Risk Breast Lesions

Radiol Clin North Am. 2021 Jan;59(1):29-40. doi: 10.1016/j.rcl.2020.08.005.


High-risk breast lesions (HRLs) are a group of heterogeneous lesions that can be associated with a synchronous or adjacent breast cancer and that confer an elevated lifetime risk of breast cancer. Management of HRLs after core needle biopsy may include close imaging and clinical follow-up or excisional biopsy to evaluate for cancer. This article reviews histologic features and clinical presentation of each of the HRLs, current evidence with regard to management, and guidelines from the American Society of Breast Surgeons and National Comprehensive Cancer Network. In addition, imaging surveillance and risk-reduction strategies for women with HRLs are discussed.

Keywords: Atypical ductal hyperplasia; Atypical lobular hyperplasia; Breast cancer; Flat epithelial atypia; High-risk lesion; Lobular carcinoma in situ; Papilloma; Radial scar.

Publication types

  • Review

MeSH terms

  • Biopsy, Large-Core Needle
  • Breast / diagnostic imaging
  • Breast / pathology
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging*
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Carcinoma, Lobular / diagnostic imaging*
  • Carcinoma, Lobular / pathology*
  • Female
  • Humans
  • Mammography / methods*
  • Risk Assessment