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Editorial

Surgical de-escalation: Are we ready for ‘observation’ of benign high-risk breast lesions found on core needle biopsy?

Holly J. Pederson, MD, Debra Pratt, MD and Benjamin C. Calhoun, MD, PhD
Cleveland Clinic Journal of Medicine July 2023, 90 (7) 433-438; DOI: https://doi.org/10.3949/ccjm.90a.23024
Holly J. Pederson
Director, Medical Breast Services, Cleveland Clinic, Cleveland, OH; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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  • For correspondence: [email protected]
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Debra Pratt
Departments of General Surgery and Breast Services, Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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Benjamin C. Calhoun
Director of Breast Pathology, Department of Pathology and Laboratory Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Associate Professor, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
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Tables

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    TABLE 1

    Curtailing therapy at age 70: Ageism?

    Current ageAdditional life expectancy, yearsEstimated total years
    7017.687.6
    7513.788.7
    8010.290.2
    857.392.3
    905.195.1
    • Data from reference 25 and 26.

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    TABLE 2

    Definitions surrounding surgical de-escalation

    Radiologic-pathologic concordanceThe imaging and pathologic findings are considered to be concordant when the pathologic result provides an acceptable explanation for the imaging feature and discordant when they do not
    OverdiagnosisFinding cases of cancer with a screening test (such as a mammography) that will never cause any symptoms
    OvertreatmentInterventions that do not benefit the patient or where the risk of harm from the intervention is likely to outweigh any benefit the patient will receive
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Cleveland Clinic Journal of Medicine: 90 (7)
Cleveland Clinic Journal of Medicine
Vol. 90, Issue 7
1 Jul 2023
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Surgical de-escalation: Are we ready for ‘observation’ of benign high-risk breast lesions found on core needle biopsy?
Holly J. Pederson, Debra Pratt, Benjamin C. Calhoun
Cleveland Clinic Journal of Medicine Jul 2023, 90 (7) 433-438; DOI: 10.3949/ccjm.90a.23024

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Surgical de-escalation: Are we ready for ‘observation’ of benign high-risk breast lesions found on core needle biopsy?
Holly J. Pederson, Debra Pratt, Benjamin C. Calhoun
Cleveland Clinic Journal of Medicine Jul 2023, 90 (7) 433-438; DOI: 10.3949/ccjm.90a.23024
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  • Article
    • BACKGROUND AND DEFINITIONS
    • SELECTING PATIENTS FOR NONOPERATIVE MANAGEMENT: CRITERIA NEEDED
    • GUIDELINE DISAGREEMENT
    • WORSENING DISPARITIES
    • OBSERVATION MAY NOT BE READY FOR WIDESPREAD IMPLEMENTATION
    • DISCLOSURES
    • REFERENCES
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