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Surgical excision for B3 breast lesions diagnosed by vacuum-assisted core biopsy.
Anticancer Res. 2010 Jun; 30(6):2287-90.AR

Abstract

The aim of this retrospective study was to assess whether open surgical excision is required following a B3 diagnosis on 11-gauge vacuum-assisted core biopsy (VACB) of radiologically indeterminate breast lesions.

PATIENTS AND METHODS

Twenty-four women with a histological diagnosis of the B3 category on VACB of radiologically indeterminate breast lesions were identified over a 3-year period. The VACB procedure was performed under stereotactic (n=21), ultrasound (n=2) or magnetic resonance imaging (MRI) (n=1) guidance using the Suros system. Nineteen patients underwent open surgical excision. The remaining 5 patients who had 'complete' removal of the radiological abnormality using VACB under ultrasound (n=2, papilloma) or stereotactic (n=4, atypical ductal hyperplasia) guidance were followed up clinically and radiologically.

RESULTS

The median patient age was 49 years. The disease status in three patients was upgraded to ductal carcinoma in situ at open surgical excision. The VACB showed atypical lobular hyperplasia in these 3 patients, associated with microcalcification (n=2) or mass lesion (n=1). No single case of upgrading to invasive breast cancer was identified in our series. The remaining patients (16 out of 19) had a benign biopsy. The upgrade to malignancy was significantly associated with the presence of atypical lobular hyperplasia, a BI-RADS category of 4 and incomplete removal of the radiological abnormality by VACB. After a mean follow-up of 18 months, no malignancy was detected in the 5 patients who did not undergo open surgical biopsy.

CONCLUSION

Open surgical excision is strongly recommended for atypical lobular hyperplasia identified in VACB specimens. VACB can be a safe alternative to surgery in the treatment of B3 lesions in selected cases, providing thorough multidisciplinary discussion has taken place.

Authors+Show Affiliations

London Breast Institute, The Princess Grace Hospital, 45 Nottingham Place, London W1U 5NY, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20651381

Citation

Reefy, S, et al. "Surgical Excision for B3 Breast Lesions Diagnosed By Vacuum-assisted Core Biopsy." Anticancer Research, vol. 30, no. 6, 2010, pp. 2287-90.
Reefy S, Osman H, Chao C, et al. Surgical excision for B3 breast lesions diagnosed by vacuum-assisted core biopsy. Anticancer Res. 2010;30(6):2287-90.
Reefy, S., Osman, H., Chao, C., Perry, N., & Mokbel, K. (2010). Surgical excision for B3 breast lesions diagnosed by vacuum-assisted core biopsy. Anticancer Research, 30(6), 2287-90.
Reefy S, et al. Surgical Excision for B3 Breast Lesions Diagnosed By Vacuum-assisted Core Biopsy. Anticancer Res. 2010;30(6):2287-90. PubMed PMID: 20651381.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical excision for B3 breast lesions diagnosed by vacuum-assisted core biopsy. AU - Reefy,S, AU - Osman,H, AU - Chao,C, AU - Perry,N, AU - Mokbel,K, PY - 2010/7/24/entrez PY - 2010/7/24/pubmed PY - 2010/8/25/medline SP - 2287 EP - 90 JF - Anticancer research JO - Anticancer Res VL - 30 IS - 6 N2 - UNLABELLED: The aim of this retrospective study was to assess whether open surgical excision is required following a B3 diagnosis on 11-gauge vacuum-assisted core biopsy (VACB) of radiologically indeterminate breast lesions. PATIENTS AND METHODS: Twenty-four women with a histological diagnosis of the B3 category on VACB of radiologically indeterminate breast lesions were identified over a 3-year period. The VACB procedure was performed under stereotactic (n=21), ultrasound (n=2) or magnetic resonance imaging (MRI) (n=1) guidance using the Suros system. Nineteen patients underwent open surgical excision. The remaining 5 patients who had 'complete' removal of the radiological abnormality using VACB under ultrasound (n=2, papilloma) or stereotactic (n=4, atypical ductal hyperplasia) guidance were followed up clinically and radiologically. RESULTS: The median patient age was 49 years. The disease status in three patients was upgraded to ductal carcinoma in situ at open surgical excision. The VACB showed atypical lobular hyperplasia in these 3 patients, associated with microcalcification (n=2) or mass lesion (n=1). No single case of upgrading to invasive breast cancer was identified in our series. The remaining patients (16 out of 19) had a benign biopsy. The upgrade to malignancy was significantly associated with the presence of atypical lobular hyperplasia, a BI-RADS category of 4 and incomplete removal of the radiological abnormality by VACB. After a mean follow-up of 18 months, no malignancy was detected in the 5 patients who did not undergo open surgical biopsy. CONCLUSION: Open surgical excision is strongly recommended for atypical lobular hyperplasia identified in VACB specimens. VACB can be a safe alternative to surgery in the treatment of B3 lesions in selected cases, providing thorough multidisciplinary discussion has taken place. SN - 1791-7530 UR - https://www.unboundmedicine.com/medline/citation/20651381/Surgical_excision_for_B3_breast_lesions_diagnosed_by_vacuum_assisted_core_biopsy_ L2 - http://ar.iiarjournals.org/cgi/pmidlookup?view=long&pmid=20651381 DB - PRIME DP - Unbound Medicine ER -