ABS Session Report

Amongst the various outstanding ABS 2017 conference sessions in Belfast, Dr Amy Degnim’s BJS Lecture was a special treat. The podium was bursting as she presented a state of the art lecture trying to resolve the puzzle “Are benign breast changes truly benign?”.  Addressing this question is a challenge to all breast specialists, yet this lecture has tackled the various aspects of this topic with outstanding brilliance.

Raising the question of how truly benign these breast lesions are, was a reminder of whether they harbour “cancer now” which one could miss on diagnostic biopsy or identify post excision, or “cancer later” highlighting the potential of future breast cancer development. This simply illustrated the basis for managing benign breast disease (BBD), and why having BBD does matter.

 

How to explain and estimate BBD risks of subsequent breast cancer diagnosis to patients is always a challenge. Using evidence from the Mayo Clinic BBD cohort of more than 13,000 patients and similar studies, Dr Degnim presented broad and straightforward relative risk estimation for different BBD groups and how to clarify associated risks to patients. 

 

Interestingly, 90% of patients in the Mayo Clinic cohort were found to be of low risk for breast cancer diagnosis. This clearly illustrates the need for more personalised management plans for BBD patients, offering surveillance, or excision through more accurate risk stratification models and future biomarker discovery. Such management models would potentially reduce unnecessary intervention and associated risk, anxiety and financial cost.

 

Without doubt this was one of the flavours of the ABS Conference in Belfast, and to wrap up this excellent session, taking into account patients’ age, lesion relative risk of cancer, histological upgrade potential, proliferation and atypia, our US colleague illustrated a more precise prediction tools improving the management of BBD. Could this herald the future towards a more efficient BBD management strategy? Only time will tell.