Breast lumps surgery

Breast lumps Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Surgery

Management of breast lumps determined by core needle biopsy

• Atypical ductal hyperplasia
  • Excision of lump by surgical consultation and follow-up with clinical breast examination for every 6-12 months accompanied with mammography annually
• Atypical lobular hyperplasia, lobular neoplasia, lobular carcinoma in situ
  • Surgical consultation and follow-up with clinical breast examination for 6-12 months accompanied with mammography annually
• Flat epithelial atypia
  • Surgical consultation and follow-up with clinical breast examination for 6-12 months accompanied with mammography annually
• Papillomas
  • Multiple, peripheral papillomas,lesions with atypia, and size >10 mm require surgical consultation and Follow-up with clinical breast examination every 12 months and mammography annually
• Complex sclerosing lesion, radical scar
  • If the size<10mm and adequately sampled, observation would be enough
  • If the size>10mm; surgical consultation is require
  • If papillomas excised; follow-up with annual clinical breast examination and mammography is required
• Fibroadenoma
  • If accompanied with atypia and enlarging size, surgical consultation is required
  • Follow-up with annual clinical breast examination and mammography
• Complex fibroadenoma
  • Observation and follow-up with clinical breast examination and mammography annually
• Sclerosing adenosis
  • Observation and follow-up with clinical breast examination and mammography annually
• Fat necrosis
  • Observation and follow-up with clinical breast examination and mammography annually
• Columnar cell hyperplasia
  • Observation and follow-up with clinical breast examination and mammography annually
• Phyllodes tumor
  • Surgical consultation is required with follow-up with clinical breast examination and mammography annually
• Desmoid tumor and mammary fibromatosis
  • Surgical consultation is required with follow-up with clinical breast examination and mammography annually
• Pseudoangiomatous stromal hyperplasia
  • In symptomatic and large lesions, surgical consultation is required with annual clinical breast examination and mammography follow-up
• Apocrine metaplasia
  • In discordant and atypic lesions, surgical consultation is required and in case of excision,follow-up with clinical breast examination and mammography annually

References

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