High risk breast lesions

Question 1

types of high risk breast lesions

Answer 1

ADH, FEA, lobular hyperplasia, LCIS, papilloma, radial scar

Question 2

definition of ADH

Answer 2

intraductal proliferation of monomorphic round nuclei that fill the duct 2mm or involve fewer than 2 ducts

Question 3

upgrade rate of ADH to DCIS

Answer 3

30%

Question 4

upgrade rate of ADH to invasive

Answer 4

10%

Question 5

typical presentation of ADH

Answer 5

calcs

Question 6

typical presentation of FEA

Answer 6

calcs

Question 7

upgrade rate of FEA to cancer

Answer 7

about 10% (really a wide range)

Question 8

lobular hyperplasia

Answer 8

refers to both ALH and LCIS (ALH is less extensive than LCIS with ALH defined as involing <50% of acini in a TDLU)

Question 9

papilloma structure

Answer 9

fibrovascular core lined by 2 cell types (inner myoepithelial layer and an outer epithelial layer

Question 10

features associated with increased upgrade risk of papilloma

Answer 10

peripheral location, large size, bloody nipple discharge, palpability

Question 11

radial scar versing complex sclerosing lesion

Answer 11

size. CSL is > 1 cm

Question 12

lifetime cancer risk for patients with LCIS

Answer 12

10-20% in women with LCIS