A.I. Burnasyan  FMBC clinical bulletin. 2025 № 4

 

S.Yu. Kaushanskaya, A.A. Zavialov, Yu.D. Udalov

Differential Diagnosis of Benign Breast Dysplasia

International Office, State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russiа

Contact person: Kaushanskaya Svetlana Yuryevna: kaushanskay78@mail.ru

 

Abstract
The topic focuses on systematizing approaches to optimize screening and reduce errors. The purpose is to synthesize data from international and domestic sources, including 2023 – 2024 publications, with quantitative risk analysis and recommendations for modern technology integration.

Method or methodology of the work: searches were conducted in PubMed, Scopus, Web of Science, and eLIBRARY.ru (2010 –2024) using keywords: “benign breast dysplasia”, “fibrocystic changes”, “differential diagnosis”, “mastopathy”. Included 27 peer-reviewed articles, reviews, and monographs (70% international) and recent Russian sources. The relevance of differential diagnosis for benign breast dysplasias arises from their high prevalence (40 – 60 % in reproductive-age women) and potential to mimic malignancies, leading to overdiagnosis and unnecessary interventions.

Results: non-proliferative forms predominate (70 –8 0 % cases, pooled RR malignancy 1.52; 95 % CI 1.34 –1.72, based on 3 sources). Mammography sensitivity – 75 % for dense tissues, ultrasound – 85 – 95 % for cystic forms. Deep learning models achieve AUC 0.943 (sensitivity 95 %). Lesion multiplicity increases risk by 25% per type (RR=1.25; 95% CI 1.10–1.42). ADH upgrade – 7.5 – 56 % (in Russia ~15 – 25 %). Interobserver biopsy Kappa – 0.65.

Scope of application of the results: optimization of protocols in oncology centers, AI integration into Russia’s FGIS healthcare system, cost-effectiveness comparison of vacuum biopsy (25 – 40 thousand RUB, 20 % reduction in repeat procedures) vs. core-needle (10 – 20 thousand RUB).

Conclusions: multimodal approach improves accuracy by 15 – 20 %, supporting the hypothesis. Personalized screening with AI and biomarkers recommended; future research – validation in Russian populations.

Keywords: benign dysplasia, mammary gland, differential diagnosis, fibrocystic changes, mammography, ultrasound examination, biopsy, mastopathy

For citation: Kaushanskaya SYu, Stepanyants NG, Udalov YuD. Differential Diagnosis of Benign Breast Dysplasia. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2025.4:71-74. (In Russian) DOI: 10.33266/2782-6430-2025-4-71-74

 

REFERENCES

1. Sung H., et al. Global Cancer Statistics 2020: Breast Cancer Epidemiology. CA: A Cancer Journal for Clinicians. 2021;71;3:209–249.
2. Kaprin A.D., Starinskaya G.V. Rak Molochnoy Zhelezy = Breast Cancer. Moscow, GEOTAR-Media Publ., 2024. 512 p. (In Russ.).
3. Hartmann L.C., et al. Benign Breast Disease and the Risk of Breast Cancer. Journal of the National Cancer Institute. 2015;107;7:1–10.
4. Santen R.J. Benign Breast Disorders. New England Journal of Medicine. 2018;378;6:528–537.
5. Petrova A.V., Pashkova V.A., Solov’yeva I.A. Dysplasia of the Mammary Gland: Modern Aspects. Klinicheskaya Onkologiya = Clinical Oncology. 2023;4:112–120 (In Russ.).
6. Dobrokachestvennaya Displaziya Molochnoy Zhelezy = Benign Breast Dysplasia. Clinical Guidelines. Approved by the Ministry of Health of Russia. Moscow Publ., 2024. 79 p. (In Russ.).
7. Elmore J.G., et al. Diagnostic Concordance among Pathologists Interpreting Breast Biopsy Specimens. Journal of the National Cancer Institute. 2020;112;5:494–502.
8. Du Y., et al. Study on the Differential Diagnosis of Benign and Malignant Breast Lesions Using a Deep Learning Model Based on Multimodal Images. Journal of Cancer Research and Therapeutics. 2024;20;2:625–632.
9. Sivarajah R.T., et al. Diffuse Unilateral MRI Breast Entities. Seminars in Roentgenology. 2024;59;4:372–380.
10. Panzironi G., et al. European Guidelines for the Diagnosis, Treatment and Follow-Up of Breast Lesions with Uncertain Malignant Potential (B3 Lesions) Developed Jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO. European Journal of Surgical Oncology. 2023;49;12:107250.
11. Starikova N.V. Risk Factors for the Development of Breast Cancer Against the Background of Benign Dysplasia. Onkologiya. Zhurnal im. P.A.Gertsena = P.A. Herzen Journal of Oncology. 2024;13;2:45–52 (In Russ.).
12. Abakumova T.V. Integration of AI in the Diagnostics of Breast Diseases. Rossiyskiy Zhurnal Onkologii = Russian Journal of Oncology. 2024;4:112–120 (In Russ.).
13. Moy L., et al. Approach to the Diagnostic Imaging of Breast Disease. Radiologic Clinics of North America. 2014;52;4:703–719.
14. Rohan T.E., et al. Multiplicity of Benign Breast Disease Lesions and Breast Cancer Risk in African American Women. Frontiers in Oncology. 2024;14:1410819.
15. Dhande R.S., et al. Histopathological Study of Benign Breast Lesions. IP Journal of Diagnostic Pathology and Oncology. 2023;6;4:272–278.
16. Erol T., et al. Assessing and Managing Benign Breast Lesions Leading to Mastalgia: a Review of 840 Patients. Turkish Journal of Surgery. 2025;41;1:1–7.
17. Visscher D.W., et al. Pathology of Benign Breast Disorders. Surgical Clinics of North America. 2017;97;4:663–679.
18. Rozhkova N.I. Benign Diseases of the Mammary Gland: Diagnosis and Treatment. Voprosy Onkologii = Problems in Oncology. 2024;70;3:210–218 (In Russ.).
19. Dutta A., et al. Prevalence, Impact, and Diagnostic Challenges of Benign Breast Disease: a Narrative Review. Cureus. 2023;15;5:e39023.

Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 12.08.2025. Accepted for publication: 25.09.2025