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Erschienen in: World Journal of Surgery 11/2013

01.11.2013

Is Mode of Presentation of B3 Breast Core Biopsies (Screen-Detected or Symptomatic) a Distinguishing Factor in the Final Histopathologic Result or Risk of Diagnosis of Malignancy?

verfasst von: Gael M. MacLean, Stephen P. Courtney, Hilary Umeh, Siriathan Sanjeev, Colin McCormick, Brendan M. Smith

Erschienen in: World Journal of Surgery | Ausgabe 11/2013

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Abstract

Background

The relation between histopathologic subclassification and mode of patient presentation (with a screen-detected vs. symptomatic lesion) with an abnormality in the breast core biopsy classified as having uncertain malignant potential (B3) has not been previously examined. We compared the histopathologic subclassification of these lesions and the frequency of malignancy in screen-detected and symptomatic patient groups.

Methods

All B3 core biopsies from one breast unit at the Royal Berkshire Hospital over a 5-year period (2006–2010) were analyzed (n = 131). After dividing the B3 biopsies into screen-detected and symptomatic groups, the National Health Service Breast Screening Programme histopathologic subclassification was used to further divide the groups into six subtypes. After surgery, a final diagnosis of invasive or in situ carcinoma was also noted.

Results

B3 classification comprised 3.8 % (131/3,440) of all core biopsies during that time period. There were 78 specimens from symptomatic (59 %) and 53 from screen-detected (41 %) patients. There was no statistically significant difference between papillary and fibroepithelial diagnoses between the two groups (47 vs. 42 %, p = 0.59, NS). There was no difference between the groups for atypia, lobular neoplasia, or sclerosing lesions (49 vs. 51 %, p = 0.8, NS). Cancer was found in 20 % of the symptomatic patients and in 17 % of the screen-detected group (p = 0.65, NS).

Conclusions

Mode of patient presentation (with a screen-detected or symptomatic lesion) was not a distinguishing factor for breast histopathologic subclassification or for the final cancer diagnosis in patients whose breast core biopsy was classified as B3.
Literatur
1.
Zurück zum Zitat Rakha E (2011) Characterization and outcome of breast needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening. Int J Cancer 129:1417–1424PubMedCrossRef Rakha E (2011) Characterization and outcome of breast needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening. Int J Cancer 129:1417–1424PubMedCrossRef
2.
Zurück zum Zitat Hayes B (2009) Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience. J Clin Pathol 62:1136–1140PubMedCrossRef Hayes B (2009) Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience. J Clin Pathol 62:1136–1140PubMedCrossRef
3.
Zurück zum Zitat El-Sayed M (2008) Predictive value of needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening. Histopathology 53:650–657PubMedCrossRef El-Sayed M (2008) Predictive value of needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening. Histopathology 53:650–657PubMedCrossRef
6.
Zurück zum Zitat Rakha E (2011) Outcome of breast lesions diagnosed as lesion of uncertain malignant potential (B3) or suspicious of malignancy (B4) on needle core biopsy, including a review of epithelial atypia. Histopathology 58:626–632PubMedCrossRef Rakha E (2011) Outcome of breast lesions diagnosed as lesion of uncertain malignant potential (B3) or suspicious of malignancy (B4) on needle core biopsy, including a review of epithelial atypia. Histopathology 58:626–632PubMedCrossRef
7.
Zurück zum Zitat Houssami N, Ciatto S (2007) Borderline breast core needle histology: predictive values for malignancy in lesions of uncertain malignant potential (B3). Br J Cancer 96:1253–1257PubMedCrossRef Houssami N, Ciatto S (2007) Borderline breast core needle histology: predictive values for malignancy in lesions of uncertain malignant potential (B3). Br J Cancer 96:1253–1257PubMedCrossRef
8.
Zurück zum Zitat Lieske B, Ravichandran D, Alvi A et al (2008) Screen-detected breast lesions with an indeterminate (B3) core needle biopsy should be excised. Eur J Surg Oncol 34:1293–1298PubMedCrossRef Lieske B, Ravichandran D, Alvi A et al (2008) Screen-detected breast lesions with an indeterminate (B3) core needle biopsy should be excised. Eur J Surg Oncol 34:1293–1298PubMedCrossRef
9.
Zurück zum Zitat Hunt RJ, Steel JR, Porter GJ et al (2012) Lesions of uncertain malignant potential (B3) on core biopsy in the NHS breast screening programme: is the screening round relevant? Ann R Coll Surg Engl 94:108–111PubMedCrossRef Hunt RJ, Steel JR, Porter GJ et al (2012) Lesions of uncertain malignant potential (B3) on core biopsy in the NHS breast screening programme: is the screening round relevant? Ann R Coll Surg Engl 94:108–111PubMedCrossRef
11.
Zurück zum Zitat Ibrahim A (2001) The role and histological classification of needle core biopsy in comparison with fine needle aspiration cytology in the preoperative assessment of impalpable breast lesions. J Clin Pathol 54:121–125PubMedCrossRef Ibrahim A (2001) The role and histological classification of needle core biopsy in comparison with fine needle aspiration cytology in the preoperative assessment of impalpable breast lesions. J Clin Pathol 54:121–125PubMedCrossRef
12.
Zurück zum Zitat Mokbel K (1999) Radial scar and carcinoma of the breast: microscopic findings in 32 cases. Breast 8:339–342PubMedCrossRef Mokbel K (1999) Radial scar and carcinoma of the breast: microscopic findings in 32 cases. Breast 8:339–342PubMedCrossRef
13.
Zurück zum Zitat Wallis M (1993) Complex sclerosing lesions (radial scars) of the breast can be palpable. Clin Radiol 48:319–320PubMedCrossRef Wallis M (1993) Complex sclerosing lesions (radial scars) of the breast can be palpable. Clin Radiol 48:319–320PubMedCrossRef
14.
Zurück zum Zitat Ung O (2001) Complex sclerosing lesion: the lesion is complex, the management is straightforward. ANZ J Surg 71:35–40PubMedCrossRef Ung O (2001) Complex sclerosing lesion: the lesion is complex, the management is straightforward. ANZ J Surg 71:35–40PubMedCrossRef
15.
Zurück zum Zitat Manfrin E, Mariotto R, Remo A et al (2009) Benign breast lesions at risk of developing cancer: a challenging problem in breast cancer screening programs: five years’ experience of the breast cancer screening program in Verona (1999–2004). Cancer 115:499–507PubMedCrossRef Manfrin E, Mariotto R, Remo A et al (2009) Benign breast lesions at risk of developing cancer: a challenging problem in breast cancer screening programs: five years’ experience of the breast cancer screening program in Verona (1999–2004). Cancer 115:499–507PubMedCrossRef
16.
Zurück zum Zitat Doyle E (2007) Radial scars/complex sclerosing lesions and malignancy in a screening programme: incidence and histological features revisited. Histopathology 50:607–614PubMedCrossRef Doyle E (2007) Radial scars/complex sclerosing lesions and malignancy in a screening programme: incidence and histological features revisited. Histopathology 50:607–614PubMedCrossRef
17.
Zurück zum Zitat Lee KA, Zuley ML, Chivukula M et al (2012) Risk of malignancy when microscopic radial scars and microscopic papillomas are found at percutaneous biopsy. AJR Am J Roentgenol 198:W141–W145PubMedCrossRef Lee KA, Zuley ML, Chivukula M et al (2012) Risk of malignancy when microscopic radial scars and microscopic papillomas are found at percutaneous biopsy. AJR Am J Roentgenol 198:W141–W145PubMedCrossRef
18.
Zurück zum Zitat Osborn G, Wilton F, Stevens G et al (2011) A review of needle core biopsy diagnosed radial scars in the Welsh breast screening programme. Ann R Coll Surg Engl 93:123–126PubMedCrossRef Osborn G, Wilton F, Stevens G et al (2011) A review of needle core biopsy diagnosed radial scars in the Welsh breast screening programme. Ann R Coll Surg Engl 93:123–126PubMedCrossRef
19.
Zurück zum Zitat Andacoglu O, Kanbour-Shakir A, Teh YC et al (2011) Rationale of excisional biopsy after the diagnosis of benign radial scar on core biopsy: a single institutional outcome analysis. Am J Clin Oncol 36:7–11CrossRef Andacoglu O, Kanbour-Shakir A, Teh YC et al (2011) Rationale of excisional biopsy after the diagnosis of benign radial scar on core biopsy: a single institutional outcome analysis. Am J Clin Oncol 36:7–11CrossRef
20.
Zurück zum Zitat Bianchi S, Giannotti E, Vanzi E et al (2012) Radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy: analysis of 49 cases from a single-centre and review of the literature. Breast 21:159–164PubMedCrossRef Bianchi S, Giannotti E, Vanzi E et al (2012) Radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy: analysis of 49 cases from a single-centre and review of the literature. Breast 21:159–164PubMedCrossRef
21.
Zurück zum Zitat Shouhed D, Amersi FF, Spurrier R et al (2012) Intraductal papillary lesions of the breast: clinical and pathological correlation. Am Surg 78:1161–1165PubMed Shouhed D, Amersi FF, Spurrier R et al (2012) Intraductal papillary lesions of the breast: clinical and pathological correlation. Am Surg 78:1161–1165PubMed
22.
Zurück zum Zitat Ciatto S, Houssami N, Ambrogetti D et al (2007) Accuracy and underestimation of malignancy of breast core needle biopsy: the Florence experience of over 4,000 consecutive biopsies. Breast Cancer Res Treat 101:291–297PubMedCrossRef Ciatto S, Houssami N, Ambrogetti D et al (2007) Accuracy and underestimation of malignancy of breast core needle biopsy: the Florence experience of over 4,000 consecutive biopsies. Breast Cancer Res Treat 101:291–297PubMedCrossRef
23.
Zurück zum Zitat Bianchi S (2011) Positive predictive value for malignancy on surgical excision of breast lesions of uncertain malignant potential (B3) diagnosed by stereotactic vacuum-assisted needle core biopsy (VANCB): a large multi-institutional study in Italy. Breast 20:264–270PubMedCrossRef Bianchi S (2011) Positive predictive value for malignancy on surgical excision of breast lesions of uncertain malignant potential (B3) diagnosed by stereotactic vacuum-assisted needle core biopsy (VANCB): a large multi-institutional study in Italy. Breast 20:264–270PubMedCrossRef
24.
Zurück zum Zitat Tonegutti M (2010) B3 breast lesions determined by vacuum-assisted biopsy: how to reduce the frequency of benign excision biopsies. Radiol Med 115:1246–1257PubMedCrossRef Tonegutti M (2010) B3 breast lesions determined by vacuum-assisted biopsy: how to reduce the frequency of benign excision biopsies. Radiol Med 115:1246–1257PubMedCrossRef
25.
Zurück zum Zitat Whitworth P (2011) Definitive diagnosis for high-risk breast lesions without open surgical excision: the Intact Percutaneous Excision Trial (IPET). Ann Surg Oncol 18:3047–3052PubMedCrossRef Whitworth P (2011) Definitive diagnosis for high-risk breast lesions without open surgical excision: the Intact Percutaneous Excision Trial (IPET). Ann Surg Oncol 18:3047–3052PubMedCrossRef
Metadaten
Titel
Is Mode of Presentation of B3 Breast Core Biopsies (Screen-Detected or Symptomatic) a Distinguishing Factor in the Final Histopathologic Result or Risk of Diagnosis of Malignancy?
verfasst von
Gael M. MacLean
Stephen P. Courtney
Hilary Umeh
Siriathan Sanjeev
Colin McCormick
Brendan M. Smith
Publikationsdatum
01.11.2013
Verlag
Springer US
Erschienen in
World Journal of Surgery / Ausgabe 11/2013
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-013-2191-6

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