Physicians’ Misunderstanding of Genetic Test Results May Hamper Mastectomy Decisions


“A recent survey of over 2,000 women newly diagnosed with breast cancer found that half of those who undergo bilateral mastectomy after genetic testing don’t actually have mutations known to confer increased risk of additional cancers, according to a study by researchers at the Stanford University School of Medicine and four other U.S. medical centers.

“Instead the women had what are known as variants of uncertain significance, or VUS, that are often eventually found to be harmless. A bilateral mastectomy is a surgical procedure in which both of a woman’s breasts are removed after a diagnosis of in one breast.”

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Surgical Excision May be Avoidable for Classic Lobular Neoplasia

The gist: Certain women with lobular neoplasia may not have to undergo surgery to remove it. Lobular neoplasia is a breast condition that indicates a higher risk of later breast cancer. Lobular neoplasia is often removed by surgery. But new research says that with a careful approach, women with classic lobular neoplasia may be treated effectively with observation and possibly drugs to prevent breast cancer. These women can avoid the potential risks of surgery.

“Surgical excision of classic lobular neoplasia diagnosed on calcification-targeting core biopsy can be avoided when careful imaging and pathology correlation is applied, according to results of a prospective study presented at the Breast Cancer Symposium.

“ ‘Lobular neoplasia, including atypical lobular hyperplasia or lobular carcinoma in situ (classic type), is a known pathologic marker of bilateral risk for subsequent breast cancer,’ Barbara Susnik, MD, of Virginia Piper Cancer Institute in Minneapolis, told HemOnc Today. ‘The management of lobular neoplasia identified on core biopsy is controversial, in that recommendations are not established and practices vary. We identified a subset of patients who can avoid surgical excision: patients with lobular neoplasia identified on stereotactic core biopsy, who presented with calcifications on mammography.’

“Susnik and colleagues analyzed 13,772 percutaneous breast core biopsy procedures performed between June 2008 and December 2013.”