Subsequent percutaneous breast biopsies after initial atypia diagnosis: The patient burden of long-term follow up

Am J Surg. 2025 Jan:239:115993. doi: 10.1016/j.amjsurg.2024.115993. Epub 2024 Sep 27.

Abstract

Background: Breast atypia increases overall breast cancer risk, potentially necessitating future interventions. This study examines the frequency and outcomes of additional percutaneous biopsies after an atypia diagnosis.

Methods: Adult patients with breast atypia (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ) at a single institution were reviewed for subsequent core needle biopsies (CNBs) and corresponding malignant outcomes.

Results: Among 432 patients, median age at diagnosis was 54.8 ​y. Seventy-one (71/432, 16.4 ​%) patients developed a breast malignancy. During a median follow-up of 7.4 ​y, 113 patients underwent 149 additional CNBs. Twenty-six patients (26/113, 23.0 ​%) had >2 additional CNBs. Approximately half (79/149, 53.0 ​%) of all additional CNBs occurred within 5 years after breast atypia diagnosis.

Conclusion: A considerable number of patients with breast atypia undergo additional percutaneous biopsies, especially within 5 years post-atypia diagnosis. Our study highlights the significant burden of surveillance and the need for tailored follow-up strategies.

Keywords: Atypical ductal hyperplasia; Atypical lobular hyperplasia; Breast atypia; Core-needle biopsy; Lobular carcinoma in-situ; Percutaneous biopsy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Large-Core Needle / statistics & numerical data
  • Breast / pathology
  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / pathology
  • Carcinoma, Intraductal, Noninfiltrating / diagnosis
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperplasia / diagnosis
  • Hyperplasia / pathology
  • Middle Aged
  • Retrospective Studies