Lesions with unclear malignant potential (B3) after minimally invasive breast biopsy: evaluation of vacuum biopsies performed in Switzerland and recommended further management. (July 2016)

• Record Type: Journal Article
• Authors: Saladin, Camilla; Haueisen, Harald; Kampmann, Gert; Oehlschlegel, Christian; Seifert, B; Rageth, Luzi; Rageth, Christoph; Stadlmann, S; Kubik-Huch, Rahel A
• Is Part Of: Acta radiologica. Volume 57:Number 7(2016:Jul.)
• Page Start: 815
• Page End: 821
• Publication Date: 2016-07
• Subjects: Breast cancer -- B3 lesion -- vacuum-assisted breast biopsy -- uncertain malignant potential -- invasive carcinoma -- ductal carcinoma in situ (DCIS); Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185115610931
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Histopathological B3 lesions after minimal invasive breast biopsy (VABB) are a particular challenge for the clinician, as there are currently no binding recommendations regarding the subsequent procedure. Purpose: To analyze all B3 lesions, diagnosed at VABB and captured in the national central Swiss MIBB database and to provide a data basis for further management in this subgroup of patients. Material and Methods: All 9, 153 stereotactically, sonographically, or magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsies, performed in Switzerland between 2009 and 2011, captured in a central database, were evaluated. The rate of B3 lesions and the definitive pathological findings in patients who underwent surgical resection were analyzed. Results: The B3 rate was 17.0% (1532 of 9000 biopsies with B classification). Among the 521 lesions with a definitive postoperative diagnosis, the malignancy rate (invasive carcinoma or DCIS) was 21.5%. In patients with atypical ductal hyperplasia, papillary lesions, flat epithelial atypia, lobular neoplasia, and radial scar diagnosed by VABB, the malignancy rates were 25.9%, 3.1%, 18.3%, 26.4%, and 11.1%, respectively. Conclusion: B3 lesions, comprising 17%, of all analyzed biopsies, were common and the proportion of malignancies in those lesions undergoing subsequent surgical excision was high (21.5%).