活检证实的乳腺病变，如非典型导管增生 (ADH) 或非典型小叶增生 (ALH)、小叶原位癌 (LCIS) 和扁平上皮异型性 (FEA) 会增加随后患乳腺癌 (BC) 的风险，但长期风险尚未合成。进行了一项系统回顾，以量化乳腺癌的未来风险，并考虑自这些高风险病变诊断以来的时间。对 2000 年以来的文献进行了系统检索，以确定报告 BC 作为芯针或切除活检组织学诊断结果的研究ADH、ALH、LCIS、小叶肿瘤 (LN) 或 FEA。对每种组织学类型进行初步诊断后，进行荟萃分析以估计每五年一次的累积 BC 发病率。70 项研究报告了 47,671 名受试者符合资格标准。高风险病变诊断后五年的 BC 发生率估计为：LCIS 为 9.3% (95% CI 6.9-12.5%)，ADH 为 6.6% (95% CI 4.4-9.7%)，ADH 为 9.7% (95 ALH 的 % CI 5.3-17.2 %)、LN 的 8.6 % (95 % CI 6.5-11.4 %)、FEA 的 3.8 % (95 % CI 1.2-11.7 %)。诊断后十年，LCIS 的 BC 发生率估计为 11.8% (95% CI 9.0-15.3%)，ADH 为 13.9% (95% CI 7.8-23.6%)，ADH 为 15.4% (95% CI 7.2-29.3) %) ALH、LN 17.0% (95% CI 7.2-35.3%) 和 FEA 7.2% (95% CI 2.2-21.2%)。我们的研究结果表明，自初次诊断高风险乳腺癌以来，BC 风险持续增加。病变，因病变类型而异，FEA 的证据相对较少。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Biopsy-proven breast lesions such as atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS) and flat epithelial atypia (FEA) increase subsequent risk of breast cancer (BC), but long-term risk has not been synthesized. A systematic review was conducted to quantify future risk of breast cancer accounting for time since diagnosis of these high-risk lesions.A systematic search of literature from 2000 was performed to identify studies reporting BC as an outcome following core-needle or excision biopsy histology diagnosis of ADH, ALH, LCIS, lobular neoplasia (LN) or FEA. Meta-analyses were conducted to estimate cumulative BC incidence at five-yearly intervals following initial diagnosis for each histology type.Seventy studies reporting on 47,671 subjects met eligibility criteria. BC incidence at five years post-diagnosis with a high-risk lesion was estimated to be 9.3 % (95 % CI 6.9-12.5 %) for LCIS, 6.6 % (95 % CI 4.4-9.7 %) for ADH, 9.7 % (95 % CI 5.3-17.2 %) for ALH, 8.6 % (95 % CI 6.5-11.4 %) for LN, and 3.8 % (95 % CI 1.2-11.7 %) for FEA. At ten years post-diagnosis, BC incidence was estimated to be 11.8 % (95 % CI 9.0-15.3 %) for LCIS, 13.9 % (95 % CI 7.8-23.6 %) for ADH, 15.4 % (95 % CI 7.2-29.3 %) for ALH, 17.0 % (95 % CI 7.2-35.3 %) for LN and 7.2 % (95 % CI 2.2-21.2 %) for FEA.Our findings demonstrate increased BC risk sustained over time since initial diagnosis of high-risk breast lesions, varying by lesion type, with relatively less evidence for FEA.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.