Objective: To determine the underestimate rate of high-risk lesions from imaging guided breast biopsy to be malignancy from subsequent surgical excision in King Chulalongkorn Memorial Hospital and to determine the factor associated to imaging characteristics and geographic data.

Materials and Methods: A retrospective review of 79 high-risk breast lesions of 78 patients who underwent imaging guided breast biopsy studies between January 1, 2010, and August 31, 2020, on women, aged 30 years or older in King Chulalongkorn Memorial Hospital. The upgrading rate of the high-risk lesions were calculated. Radiologic findings were analyzed by SPSS version 26.

Results: Seventy-nine lesions were divided into three groups with 24 lesions of atypical ductal hyperplasia (ADH), 50 lesions of the papillary lesion, and five lesions of the complex sclerosing lesion. The authors found that the upgrade rate was about 58% in the ADH group, 28% in the papillary lesion group, and 20% in the complex sclerosing lesion group. Moreover, the authors found an increased upgrade rate among patient 50 years or older (43%) as compared with fourteen patients age under 50 years (32%). However, there was no statistically significant difference in radiologic findings or factors associated with upgrading rate to malignancy under subsequent surgical excision.

Conclusion: Upgrading rate of high-risk lesions including ADH, papillary lesions, and complex sclerosing lesion were high in each lesion and the upgrade rate increased slightly in patient 50 years or older. However, there was no demonstrable radiologic manifestation or factor associated with upgrading to malignancy at subsequent surgical excision. Hence, radiologic-pathologic correlation or multidisciplinary discussion will be important roles in management of high-risk lesions.

Keywords: Breast; High risk lesion; Atypical ductal hyperplasia (ADH); Papillary lesions; Radial scar; Complex sclerosing lesion

DOI: 10.35755/jmedassocthai.2022.04.12440

Received 27 July 2021 | Revised 4 February 2022 | Accepted 4 February 2022