Risk management recommendations and patient acceptance vary with high-risk breast lesions

Anna C Beck; Sophia L Fu; Junlin Liao; Amani Bashir; Sonia L Sugg; Lillian M Erdahl; Ronald J Weigel; Ingrid M Lizarraga

doi:10.1016/j.amjsurg.2021.07.020

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Risk management recommendations and patient acceptance vary with high-risk breast lesions

Journal article

Peer reviewed

Risk management recommendations and patient acceptance vary with high-risk breast lesions

Anna C Beck, Sophia L Fu, Junlin Liao, Amani Bashir, Sonia L Sugg, Lillian M Erdahl, Ronald J Weigel and Ingrid M Lizarraga

The American journal of surgery, Vol.223(1), pp.94-100

2021

DOI: 10.1016/j.amjsurg.2021.07.020

PMID: 34325908

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Abstract

Lobular carcinoma in situ (LCIS), atypical ductal and lobular hyperplasia (AH) increase breast cancer risk. We examined risk management recommendations (RMR) and acceptance in AH/LCIS. All patients with AH/LCIS on core needle biopsy from 2013 to 2016 at our institution were identified; cancer patients were excluded. Univariate and multivariate analysis examined factors associated with management. 98 % of patients were evaluated by breast surgeons and 53 % underwent risk model calculation (RC). 77 % had new RMR. RMR of MRI screening (MRI), genetic counselling (GC) and medical oncology (MO) referral were 41 %, 18 %, 77 %, respectively. MRI screening was more likely recommended in those with strong family history (p = 0.01), and high RC (p < 0.001). Uptake of at least one RMR did not occur in 84 % of patients. Use of RC correlated with MO acceptance (p = 0.049). Diagnosis of atypia has the potential to change risk management for most, however only 16 % of patients accepted all RMR. •77 % of patients had new risk management recommendations with diagnosis of AH/LCIS.•84 % of patients did not accept at least one risk reducing recommendation.•Using a risk model was associated with uptake of medical oncology referral.

Atypical hyperplasia

LCIS

Risk reduction

The gail model

Tyrer-cuzick model

Details

Title: Subtitle: Risk management recommendations and patient acceptance vary with high-risk breast lesions
Creators: Anna C Beck - University of Iowa Hospitals and Clinics
Sophia L Fu - Good Samaritan University Hospital
Junlin Liao - University of Iowa Hospitals and Clinics
Amani Bashir - University of Iowa Hospitals and Clinics
Sonia L Sugg - University of Iowa Hospitals and Clinics
Lillian M Erdahl - University of Iowa Hospitals and Clinics
Ronald J Weigel - University of Iowa Hospitals and Clinics
Ingrid M Lizarraga - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: The American journal of surgery, Vol.223(1), pp.94-100
DOI: 10.1016/j.amjsurg.2021.07.020
PMID: 34325908
NLM abbreviation: Am J Surg
ISSN: 0002-9610
eISSN: 1879-1883
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health, award: T32CA148062
Language: English
Date published: 2021
Academic Unit: Molecular Physiology and Biophysics; Anatomy and Cell Biology; Pathology; Surgery; Biochemistry and Molecular Biology
Record Identifier: 9984185277402771

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