Precancerous breast lesions in benign breast lesions: Review of 430 benign breast lesions

Shirish S Chandanwale, Supreet Kaur, Rahul Nair, Jay Y Sheth, Sanjyot Nikam, Jehan Nizam Ansari, Manpreet Kaur, Ashily Koshy

Clinical Cancer Investigation Journal 2017 6(1):30-34

Background: Unanimously recognized precancerous breast lesions are atypical ductal hyperplasia (ADH), atypical lobular hyperplasia, flat epithelial atypia, lobular carcinoma in situ, papillary lesions, and proliferative radial scar. The increased risk of developing carcinoma associated with these lesions is found for both ipsi- and contra-lateral breasts. These precancerous lesions are also found in benign breast lesions. Aim: The aim of this study is to study histomorphological features of precancerous breast lesions and to find the prevalence of these lesions in various benign breast lesions in different age groups. Materials and Methods: We evaluated histomorphology of 430 benign breast lesions for the presence of precancerous breast lesions. The frequency of precancerous lesions was correlated with type of benign breast lesions and different age groups. Results: In thirty cases of benign breast lesions, precancerous lesions were found. Maximum cases were of lobular neoplasia (LN) (n = 12) followed by papilloma (n = 9). Majority of the lesions were found between 31 and 40 years (n = 16). Maximum cases of LN (n = 6) and ADH and peripheral papilloma each (n = 4) were seen in the age group of 31–40 years. Maximum precancerous lesions were seen in fibrocystic change (n = 21), followed by sclerosing adenosis (n = 5), and fibroadenoma (n = 4). Conclusion: Prevention is a highly feasible approach to breast cancer control. Benign breast lesions with associated precancerous breast lesions must be separated from pure benign breast lesions. These lesions need future evaluations to assess the risk of carcinoma in ipsilateral as well as contralateral breasts. There is a need for more long-term follow-up studies of precancerous breast lesions in benign breast lesions to assess the risk of developing carcinoma in ipsilateral as well as contralateral breasts.

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