Histology of, and age at prognosis for, RS/CSL and papillary lesions with out atypia. Credit score: Histopathology (2025). DOI: 10.1111/his.70017
Researchers at King’s have discovered that sure breast lesions recognized throughout routine screening might not all the time require elimination. The findings might assist scale back pointless procedures whereas sustaining excessive requirements of affected person security.
The research, revealed in Histopathology, examined outcomes for girls recognized with two forms of non-cancerous breast tissue modifications: radial scars/complicated sclerosing lesions (RS/CSL) and papillary lesions when these didn’t present atypia, that means irregular modifications in cell dimension, form, or group that may point out the next future most cancers threat.
At present, many ladies with these findings bear vacuum-assisted excision (VAE), a minimally invasive process used to take away extra tissue for testing. Nonetheless, the analysis means that some sufferers might not want this process and will as a substitute be safely monitored with mammographic surveillance.
Between 2017 and 2023, researchers from King’s reviewed circumstances on the King’s Faculty Hospital Breast Screening Unit. They discovered that only one% of girls with RS/CSL and 4% of girls with papillary lesions have been later discovered to have most cancers on the biopsy website. These outcomes point out that, for RS/CSL specifically, the probability of malignancy is low, suggesting that some sufferers might be managed via ongoing imaging quite than excision.
“We are among the first in the UK to add to the growing body of evidence that suggests that women who have RS/CSL without atypia could avoid excision. Rather, the data suggests that we could observe these lesions. This less invasive approach could improve how we care for a subset of patients in the Southeast going forward,” says Dr. Kalnisha Naidoo, Adjunct Senior Lecturer in Translational Pathology and senior creator.
Dr. Naidoo continued, “On the other hand, our study highlights that more work is needed in understanding papillary lesions, which appear to carry a higher risk of malignancy even in the absence of atypia. This is something we aim to follow up on in our service over the next few years.”
Whereas the findings spotlight the potential to scale back overtreatment and enhance affected person expertise, the authors emphasize the significance of constant nationwide reporting of most of these lesions. Variation in how atypia is recorded inside the NHS Breast Screening Programme at present makes it tough to match information between facilities and to develop standardized nationwide pointers.
“We hope our findings will help reduce unnecessary excisions for patients with RS/CSL and encourage other centers to evaluate their outcomes for papillary lesions without atypia, with the aim of developing evidence-based standardized national guidelines,” says Dr. Amy Llewellyn, Histopathology Registrar and Ph.D. pupil.
Extra data:
Amy Llewellyn et al, To VAE or to not VAE: outcomes of radial scars/complicated sclerosing lesions and papillary lesions with out atypia within the King’s Faculty Hospital breast service (2017–2023), Histopathology (2025). DOI: 10.1111/his.70017
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Surgical procedure will not be required for some breast lesions, analysis suggests (2025, October 9)
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