{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T14:02:40Z","timestamp":1792936960671,"version":"4.5.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"1154","license":[{"start":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T00:00:00Z","timestamp":1703030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006662","name":"NIHR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research for Patient Benefit Call","award":["NIHR202220"],"award-info":[{"award-number":["NIHR202220"]}]},{"DOI":"10.13039\/501100018956","name":"Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","award":["BRC-1215-20014"],"award-info":[{"award-number":["BRC-1215-20014"]}],"id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Evidence-based clinical guidelines are essential to maximize patient benefit and to reduce clinical uncertainty and inconsistency in clinical practice. Gaps in the evidence base can be addressed by data acquired in routine practice. At present, there is no international consensus on management of women diagnosed with atypical lesions in breast screening programmes. Here, we describe how routine NHS breast screening data collected by the Sloane atypia project was used to inform a management pathway that maximizes early detection of cancer and minimizes over-investigation of lesions with uncertain malignant potential. A half-day consensus meeting with 11 clinical experts, 1 representative from Independent Cancer Patients\u2019 Voice, 6 representatives from NHS England (NHSE) including from Commissioning, and 2 researchers was held to facilitate discussions of findings from an analysis of the Sloane atypia project. Key considerations of the expert group in terms of the management of women with screen detected atypia were: (1) frequency and purpose of follow-up; (2) communication to patients; (3) generalizability of study results; and (4) workforce challenges. The group concurred that the new evidence does not support annual surveillance mammography for women with atypia, irrespective of type of lesion, or woman\u2019s age. Continued data collection is paramount to monitor and audit the change in recommendations.<\/jats:p>","DOI":"10.1093\/bjr\/tqad053","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T19:16:30Z","timestamp":1704827790000},"page":"324-330","source":"Crossref","is-referenced-by-count":6,"title":["Evidence-informed recommendations on managing breast screening atypia: perspectives from an expert panel consensus meeting reviewing results from the Sloane atypia project"],"prefix":"10.1093","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9963-2918","authenticated-orcid":false,"given":"Karoline","family":"Freeman","sequence":"first","affiliation":[{"name":"Warwick Screening, Division of Health Sciences, Warwick Medical School, University of Warwick , Coventry CV4 7AL, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Mansbridge","sequence":"additional","affiliation":[{"name":"Warwick Screening, Division of Health Sciences, Warwick Medical School, University of Warwick , Coventry CV4 7AL, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Stobart","sequence":"additional","affiliation":[{"name":"Independent Cancer Patients\u2019 Voice , London, EC1R 0LL, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Clements","sequence":"additional","affiliation":[{"name":"Screening Quality Assurance Service, NHS England , Birmingham, B2 4BH, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G","family":"Wallis","sequence":"additional","affiliation":[{"name":"Cambridge Breast Unit and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Trust , Cambridge CB2 0QQ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E","family":"Pinder","sequence":"additional","affiliation":[{"name":"School of Cancer & Pharmaceutical Sciences, King\u2019s College London, Comprehensive Cancer Centre at Guy\u2019s Hospital, King\u2019s College London , London SE1 9RT, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olive","family":"Kearins","sequence":"additional","affiliation":[{"name":"Screening Quality Assurance Service, NHS England , Birmingham, B2 4BH, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer M","family":"Shaaban","sequence":"additional","affiliation":[{"name":"Breast Unit, Queen Elizabeth Hospital Birmingham and University of Birmingham, Edgbaston , Birmingham B15 2GW, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cliona C","family":"Kirwan","sequence":"additional","affiliation":[{"name":"Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M20 4BX, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise S","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Oxford Breast Imaging Service, Churchill Hospital , Oxford OX3 7LE, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Webb","sequence":"additional","affiliation":[{"name":"Public Health Commissioning and Operations, Directorate of the Chief Operating Officer, NHS England , London, SE1 8UG, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Public Health Commissioning and Operations, Directorate of the Chief Operating Officer, NHS England , London, SE1 8UG, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquie","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Public Health Commissioning and Operations, Directorate of the Chief Operating Officer, NHS England , London, SE1 8UG, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Wright","sequence":"additional","affiliation":[{"name":"Public Health Commissioning and Operations, Directorate of the Chief Operating Officer, NHS England , London, SE1 8UG, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Taylor","sequence":"additional","affiliation":[{"name":"Cambridge Breast Unit and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Trust , Cambridge CB2 0QQ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Bailey","sequence":"additional","affiliation":[{"name":"SW London Breast Screening Service, St George\u2019s University Hospitals NHS Foundation Trust, London, SW17 0QT, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Holcombe","sequence":"additional","affiliation":[{"name":"Association of Breast Surgery, Royal College of Surgeons of England , London WC2A 3PE, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4046-5940","authenticated-orcid":false,"given":"Lynda","family":"Wyld","sequence":"additional","affiliation":[{"name":"Department of Oncology and Metabolism, University of Sheffield , Sheffield S10 2RX, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Edwards","sequence":"additional","affiliation":[{"name":"Breast Test Wales, Public Health Wales , Llandudno LL30 1QY, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Jenkinson","sequence":"additional","affiliation":[{"name":"Warwick Screening, Division of Health Sciences, Warwick Medical School, University of Warwick , Coventry CV4 7AL, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Breast Screening Unit, Seacroft Hospital , Leeds LS14 6UH, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Provenzano","sequence":"additional","affiliation":[{"name":"Histopathology and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust , Cambridge CB2 0QQ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Hilton","sequence":"additional","affiliation":[{"name":"Screening Quality Assurance Service, NHS England , Birmingham, B2 4BH, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7781-1512","authenticated-orcid":false,"given":"Nigel","family":"Stallard","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick , Coventry CV4 7AL, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair M","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine , Houston, TX 77005, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1841-4346","authenticated-orcid":false,"given":"Sian","family":"Taylor-Phillips","sequence":"additional","affiliation":[{"name":"Warwick Screening, Division of Health Sciences, Warwick Medical School, University of Warwick , Coventry CV4 7AL, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,20]]},"reference":[{"issue":"3","key":"2024020301471670400_tqad053-B1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s10549-014-3254-6","article-title":"Breast cancer risk associated with benign breast disease: systematic review and meta-analysis","volume":"149","author":"Dyrstad","year":"2015","journal-title":"Breast Cancer Res Treat"},{"issue":"33","key":"2024020301471670400_tqad053-B2","doi-asserted-by":"crossref","first-page":"3945","DOI":"10.1200\/JCO.2015.61.4743","article-title":"Lobular carcinoma in situ: a 29-year longitudinal experience evaluating clinicopathologic features and breast cancer risk","volume":"33","author":"King","year":"2015","journal-title":"J Clin Oncol"},{"issue":"24","key":"2024020301471670400_tqad053-B3","doi-asserted-by":"crossref","first-page":"5534","DOI":"10.1200\/JCO.2005.04.038","article-title":"Bilateral risk for subsequent breast cancer after lobular carcinoma-in-situ: analysis of surveillance, epidemiology, and end results data","volume":"23","author":"Chuba","year":"2005","journal-title":"J Clin Oncol"},{"issue":"3","key":"2024020301471670400_tqad053-B4","doi-asserted-by":"crossref","first-page":"e353","DOI":"10.1016\/j.clbc.2019.12.009","article-title":"Three-year trends in diagnosis of B3 breast lesions and their upgrade rates to malignant lesions","volume":"20","author":"Griffiths","year":"2020","journal-title":"Clin Breast Cancer"},{"issue":"4","key":"2024020301471670400_tqad053-B5","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.ejso.2018.12.008","article-title":"High risk (B3) breast lesions: What is the incidence of malignancy for individual lesion subtypes? A systematic review and meta-analysis","volume":"45","author":"Forester","year":"2019","journal-title":"Eur J Surg Oncol"},{"issue":"6","key":"2024020301471670400_tqad053-B6","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/j.1365-2559.2008.03158.x","article-title":"Predictive value of needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening","volume":"53","author":"El-Sayed","year":"2008","journal-title":"Histopathology"},{"issue":"1","key":"2024020301471670400_tqad053-B7","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.breast.2006.06.009","article-title":"Breast core biopsy reporting categories\u2014an internal validation in a series of 3054 consecutive lesions","volume":"16","author":"Andreu","year":"2007","journal-title":"Breast"},{"issue":"8","key":"2024020301471670400_tqad053-B8","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.crad.2018.04.004","article-title":"NHS Breast Screening multidisciplinary working group guidelines for the diagnosis and management of breast lesions of uncertain malignant potential on core biopsy (B3 lesions)","volume":"73","author":"Pinder","year":"2018","journal-title":"Clin Radiol"},{"key":"2024020301471670400_tqad053-B9"},{"issue":"12","key":"2024020301471670400_tqad053-B10","doi-asserted-by":"crossref","first-page":"e061585","DOI":"10.1136\/bmjopen-2022-061585","article-title":"Cohort profile of the Sloane Project: methodology for a prospective UK cohort study of &gt;15 000 women with screen-detected non-invasive breast neoplasia","volume":"12","author":"Clements","year":"2022","journal-title":"BMJ Open"},{"key":"2024020301471670400_tqad053-B11","author":"Breast Test Wales","year":"2017"},{"issue":"3","key":"2024020301471670400_tqad053-B12","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1093\/jbi\/wbab024","article-title":"Anxiety and its association with screening mammography","volume":"3","author":"Loving","year":"2021","journal-title":"J Breast Imaging"},{"key":"2024020301471670400_tqad053-B13","first-page":"e077039","article-title":"Sloane Project Steering Group. Breast screening atypia and subsequent development of cancer: observational analysis of the Sloane atypia prospective cohort in England","volume":"384","year":"2024","journal-title":"BMJ"}],"container-title":["British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqad053\/56352818\/tqad053.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/97\/1154\/324\/56556275\/tqad053.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/97\/1154\/324\/56556275\/tqad053.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T20:47:35Z","timestamp":1706906855000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/97\/1154\/324\/7484657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,20]]},"references-count":13,"journal-issue":{"issue":"1154","published-online":{"date-parts":[[2023,12,20]]},"published-print":{"date-parts":[[2024,2,2]]}},"URL":"https:\/\/doi.org\/10.1093\/bjr\/tqad053","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,2,1]]},"published":{"date-parts":[[2023,12,20]]}}}