B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies

The rate of upgrade to cancer for breast lesions with uncertain malignant potential (B3 lesions) diagnosed at needle biopsy is highly influenced by several factors, but large series are seldom available. We retrospectively assessed the upgrade rates of a consecutive series of B3 lesions diagnosed at...

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Autores principales:	Veronica Girardi, Monica Guaragni, Nella Ruzzenenti, Fabrizio Palmieri, Gianluca Fogazzi, Andrea Cozzi, Diana Lucchini, Alberto Buffoli, Simone Schiaffino, Francesco Sardanelli
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	breast neoplasms high-risk lesions B3 lesions ultrasonography mammography image-guided biopsy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/26a9a7195e10472bb837d69bffafb747
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spelling	oai:doaj.org-article:26a9a7195e10472bb837d69bffafb7472021-11-11T15:32:17ZB3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies10.3390/cancers132154432072-6694https://doaj.org/article/26a9a7195e10472bb837d69bffafb7472021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5443https://doaj.org/toc/2072-6694The rate of upgrade to cancer for breast lesions with uncertain malignant potential (B3 lesions) diagnosed at needle biopsy is highly influenced by several factors, but large series are seldom available. We retrospectively assessed the upgrade rates of a consecutive series of B3 lesions diagnosed at ultrasound- or mammography-guided vacuum-assisted biopsy (VAB) at an EUSOMA-certified Breast Unit over a 7-year timeframe. The upgrade rate was defined as the number of ductal carcinoma in situ (DCIS) or invasive cancer at pathology after excision or during follow-up divided by the total number of B3 lesions. All lesions were reviewed by one of four pathologists with a second opinion for discordant assessments of borderline cases. Excision or surveillance were defined by the multidisciplinary tumor board, with 6- and 12-month follow-up. Out of 3634 VABs (63% ultrasound-guided), 604 (17%) yielded a B3 lesion. After excision, 17/604 B3 lesions were finally upgraded to malignancy (2.8%, 95% confidence interval [CI] 1.8–4.5%), 10/17 (59%) being upgraded to DCIS and 7/17 (41%) to invasive carcinoma. No cases were upgraded during follow-up. B3a lesions showed a significantly lower upgrade rate (0.4%, 95% CI 0.1–2.1%) than B3b lesions (4.7%, 95% CI 2.9–7.5%, <i>p</i> = 0.001), that had a 22.0 adjusted odds ratio for upgrade (95% CI 2.1–232.3). No significant difference was found in upgrade rates according to imaging guidance or needle caliper. Surveillance-oriented management can be considered for B3a lesions, while surgical excision should be pursued for B3b lesions.Veronica GirardiMonica GuaragniNella RuzzenentiFabrizio PalmieriGianluca FogazziAndrea CozziDiana LucchiniAlberto BuffoliSimone SchiaffinoFrancesco SardanelliMDPI AGarticlebreast neoplasmshigh-risk lesionsB3 lesionsultrasonographymammographyimage-guided biopsyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5443, p 5443 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	breast neoplasms high-risk lesions B3 lesions ultrasonography mammography image-guided biopsy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	breast neoplasms high-risk lesions B3 lesions ultrasonography mammography image-guided biopsy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Veronica Girardi Monica Guaragni Nella Ruzzenenti Fabrizio Palmieri Gianluca Fogazzi Andrea Cozzi Diana Lucchini Alberto Buffoli Simone Schiaffino Francesco Sardanelli B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies
description	The rate of upgrade to cancer for breast lesions with uncertain malignant potential (B3 lesions) diagnosed at needle biopsy is highly influenced by several factors, but large series are seldom available. We retrospectively assessed the upgrade rates of a consecutive series of B3 lesions diagnosed at ultrasound- or mammography-guided vacuum-assisted biopsy (VAB) at an EUSOMA-certified Breast Unit over a 7-year timeframe. The upgrade rate was defined as the number of ductal carcinoma in situ (DCIS) or invasive cancer at pathology after excision or during follow-up divided by the total number of B3 lesions. All lesions were reviewed by one of four pathologists with a second opinion for discordant assessments of borderline cases. Excision or surveillance were defined by the multidisciplinary tumor board, with 6- and 12-month follow-up. Out of 3634 VABs (63% ultrasound-guided), 604 (17%) yielded a B3 lesion. After excision, 17/604 B3 lesions were finally upgraded to malignancy (2.8%, 95% confidence interval [CI] 1.8–4.5%), 10/17 (59%) being upgraded to DCIS and 7/17 (41%) to invasive carcinoma. No cases were upgraded during follow-up. B3a lesions showed a significantly lower upgrade rate (0.4%, 95% CI 0.1–2.1%) than B3b lesions (4.7%, 95% CI 2.9–7.5%, <i>p</i> = 0.001), that had a 22.0 adjusted odds ratio for upgrade (95% CI 2.1–232.3). No significant difference was found in upgrade rates according to imaging guidance or needle caliper. Surveillance-oriented management can be considered for B3a lesions, while surgical excision should be pursued for B3b lesions.
format	article
author	Veronica Girardi Monica Guaragni Nella Ruzzenenti Fabrizio Palmieri Gianluca Fogazzi Andrea Cozzi Diana Lucchini Alberto Buffoli Simone Schiaffino Francesco Sardanelli
author_facet	Veronica Girardi Monica Guaragni Nella Ruzzenenti Fabrizio Palmieri Gianluca Fogazzi Andrea Cozzi Diana Lucchini Alberto Buffoli Simone Schiaffino Francesco Sardanelli
author_sort	Veronica Girardi
title	B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies
title_short	B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies
title_full	B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies
title_fullStr	B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies
title_full_unstemmed	B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies
title_sort	b3 lesions at vacuum-assisted breast biopsy under ultrasound or mammography guidance: a single-center experience on 3634 consecutive biopsies
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/26a9a7195e10472bb837d69bffafb747
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B3 Lesions at Vacuum-Assisted Breast Biopsy under Ultrasound or Mammography Guidance: A Single-Center Experience on 3634 Consecutive Biopsies

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