{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T07:22:24Z","timestamp":1772349744648,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>High-risk breast lesions including incidental intraductal papilloma without atypia (IPA), lobular hyperplasia (LCIS or ALH), flat epithelial atypia (FEA) and complex sclerosing lesion (CSL) are not routinely excised due to low upgrade rates to carcinoma. We aim to identify features of these lesions predictive of upgrade when identified concurrently with invasive disease. Methods: A single-center retrospective cohort study was performed for patients who underwent multi-site lumpectomies with invasive disease at one site and a high-risk lesion at another site between 2006 and 2021. A multinomial logistic regression was performed. Results: Sixty-five patients met the inclusion criteria. Four patients (6.2%) had an upgrade to in situ disease (DCIS) and one (1.5%) to invasive carcinoma. Three upgraded high-risk lesions were ipsilateral to the concurrent carcinoma and two were contralateral. In the multivariate model, a high-risk lesion within 5 cm of an ipsilateral malignancy was associated with increased risk of upgrade. The 3.8% upgrade rate for high-risk lesions located greater than 5 cm from ipsilateral malignancy or in the contralateral breast suggests that omission of excisional biopsy may be considered. Excisional biopsy of lesions within 5 cm of ipsilateral malignancy is recommended given the 25% upgrade risk in our series.<\/jats:p>","DOI":"10.3390\/cancers16122268","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T08:06:06Z","timestamp":1718784366000},"page":"2268","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Distance of Biopsy-Confirmed High-Risk Breast Lesion from Concurrently Identified Breast Malignancy Associated with Risk of Carcinoma at the High-Risk Lesion Site"],"prefix":"10.3390","volume":"16","author":[{"given":"Julie","family":"Le","sequence":"first","affiliation":[{"name":"Division of Breast Surgery, The Comprehensive Breast Health Center, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas J.","family":"O\u2019Keefe","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jennifer Moreno Department of Veterans Affairs Medical Center, La Jolla, CA 92161, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sohini","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5851-4627","authenticated-orcid":false,"given":"Sara M.","family":"Grossi","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, The Comprehensive Breast Health Center, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"},{"name":"Department of Surgery, Jennifer Moreno Department of Veterans Affairs Medical Center, La Jolla, CA 92161, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3714-5700","authenticated-orcid":false,"given":"Hye Young","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Breast Imaging, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"},{"name":"Department of Medicine, Gyeongsang National University College of Medicine, Jinju-si 52727, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3773-0050","authenticated-orcid":false,"given":"Haydee","family":"Ojeda-Fournier","sequence":"additional","affiliation":[{"name":"Division of Breast Imaging, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3731-2182","authenticated-orcid":false,"given":"Ava","family":"Armani","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, The Comprehensive Breast Health Center, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne M.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, The Comprehensive Breast Health Center, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah L.","family":"Blair","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, The Comprehensive Breast Health Center, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1159\/000489096","article-title":"Intraductal Papilloma without Atypia on Image-Guided Breast Biopsy: Upgrade Rates to Carcinoma at Surgical Excision","volume":"13","author":"Leithner","year":"2018","journal-title":"Breast Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40137-018-0201-1","article-title":"Non-classic LCIS versus Classic LCIS versus Atypical Hyperplasia: Should Management be the Same?","volume":"6","author":"Nakhlis","year":"2018","journal-title":"Curr. 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