A survey of Canadian breast health professionals’ recommendations for high-risk benign breast disease

A survey of Canadian breast health professionals’ recommendations for high-risk benign breast disease

Can J Surg 2019;62(5):358-360 | Full Text | PDF

Coralea Kappel, MD; Jean Seely, MD; James Watters, MD; Angel Arnaout, MD, MSc; Erin Cordeiro, MD, MSc


The management of high-risk benign breast disease (BBD) is changing because of improvements in radiological and pathological analysis. We sought to determine the current practice recommendations of breast health professionals in managing patients with high-risk BBD. We surveyed members of the Canadian Society of Surgical Oncology, Canadian Association of General Surgeons and Canadian Association of Radiologists. The survey contained demographic and case-based questions concerning management of high-risk benign breast lesions. Participants were asked for their recommendations and opinions regarding future risk of breast cancer as well as the role of chemoprevention. There was no consistency among the 41 respondents in the treatment recommendations for any of the high-risk benign conditions, and the lifetime risk associated with classic lobular carcinoma in situ was vastly underestimated. Education and evidenced-based guidelines are urgently needed to ensure more uniform practice nationally.

This work was presented in abstract form at the American Society of Breast Surgeons Meeting, Las Vegas, NV, April 2017

Accepted Jan. 2, 2019; Early-released Aug. 1, 2019

Affiliations: From the Department of Medicine, McMaster University, Hamilton, Ont. (Kappel); the Departments of Diagnostic Imaging (Seely) and Surgery (Watters, Arnaout, Cordeiro), The Ottawa Hospital, Ottawa, Ont.; and the Ottawa Hospital Research Institute, Ottawa, Ont. (Seely, Watters, Arnaout, Cordeiro).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.009018

Correspondence to: E. Cordeiro, The Ottawa Hospital, 501 Smyth Rd., Box 202, Ottawa ON K1H 8L6, ecordeiro@toh.on.ca