Management of high-risk lesions

Although all women are at risk of breast cancer, a particularly high risk is associated with the presence of specific changes in the breast. These include epithelial atypia documented on breast biopsy [1, 2], and extremely dense breast tissue on mammography [3]. Today, these conditions are mainly discovered on imaging and documented with image-guided core needle biopsy. Knowledge of the appropriate management of women with high-risk breast lesions is essential to guide decisions regarding the need for surgical excision, intense surveillance, and preventive interventions, either medical or surgical. This chapter summarizes the risk of malignancy associated with specific high risk lesions as well as the appropriate surveillance and management of such lesions.