Was Your Breast Biopsy Really Benign?

I see many patients on a daily basis who indicate on their history forms that they have had a benign breast biopsy. However, many of these patients do not know the specific results of their biopsy.

All breast biopsies are sent to a pathologist to be analyzed, who then issues a pathology report which details the specific diagnosis associated with the breast tissue sent in from the breast biopsy.  In certain larger medical centers, the pathologist analyzing the breast biopsy is a sub-specialist in breast pathology (a pathologist who has done formal fellowship training in breast pathology).

Breast Biopsies are generally classified into two categories: “benign” (meaning no evidence of cancer) and “malignant” (or cancerous). However, many patients are unaware that the “benign” breast biopsies are further classified into two further categories:  “truly” benign and high-risk.

Benign breast biopsies classified as “high risk” refer to those biopsies that identify breast tissue which is either pre-cancerous (e.g. over time, this breast tissue would turn into cancer) or breast tissue which is abnormal and often seen in women who already have or will develop breast cancer.

Commonly seen “high risk” breast biopsies include, but not limited to,  atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), atypical columnar cell change (sometimes called flat epithelial atypia or FEA), radial scar, papillomatosis, and papilloma.

Because of the increased breast cancer risk, women who are diagnosed with a “high risk” breast biopsy need further medical treatment. The first step is to identify a center with a dedicated fellowship-trained breast radiologist and undergo a breast MRI examination to identify how extensive the “high risk” process is within the breast tissue.  The second step is to schedule a consultation with a breast surgeon to determine the need for surgical removal of the part of the breast affected by the “high-risk” process. Some women will also require a consultation with a breast oncologist regarding different medicines that can be taken to help with their specific condition.

Therefore, it is very important that if you have been diagnosed with a “benign breast biopsy,” that you know the very specifics of the diagnosis, as not all “benign” breast biopsies are “truly” benign. It is your right to obtain the pathology report associated with your breast biopsy. This report will give you the specific result of the breast biopsy that you underwent.

Dr. Thomas Bakondy, MD

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