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Open Access 30.11.2018 | Review

Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

verfasst von: Christoph J. Rageth, Elizabeth A. M. O’Flynn, Katja Pinker, Rahel A. Kubik-Huch, Alexander Mundinger, Thomas Decker, Christoph Tausch, Florian Dammann, Pascal A. Baltzer, Eva Maria Fallenberg, Maria P. Foschini, Sophie Dellas, Michael Knauer, Caroline Malhaire, Martin Sonnenschein, Andreas Boos, Elisabeth Morris, Zsuzsanna Varga

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2019

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Abstract

Purpose

The second International Consensus Conference on B3 lesions was held in Zurich, Switzerland, in March 2018, organized by the International Breast Ultrasound School to re-evaluate the consensus recommendations.

Methods

This study (1) evaluated how management recommendations of the first Zurich Consensus Conference of 2016 on B3 lesions had influenced daily practice and (2) reviewed current literature towards recommendations to biopsy.

Results

In 2018, the consensus recommendations for management of B3 lesions remained almost unchanged: For flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL) and radial scars (RS) diagnosed on core-needle biopsy (CNB) or vacuum-assisted biopsy (VAB), excision by VAB in preference to open surgery, and for atypical ductal hyperplasia (ADH) and phyllodes tumors (PT) diagnosed at VAB or CNB, first-line open surgical excision (OE) with follow-up surveillance imaging for 5 years. Analyzing the Database of the Swiss Minimally Invasive Breast Biopsies (MIBB) with more than 30,000 procedures recorded, there was a significant increase in recommending more frequent surveillance of LN [65% in 2018 vs. 51% in 2016 (p = 0.004)], FEA (72% in 2018 vs. 62% in 2016 (p = 0.005)), and PL [(76% in 2018 vs. 70% in 2016 (p = 0.04)] diagnosed on VAB. A trend to more frequent surveillance was also noted also for RS [77% in 2018 vs. 67% in 2016 (p = 0.07)].

Conclusions

Minimally invasive management of B3 lesions (except ADH and PT) with VAB continues to be appropriate as an alternative to first-line OE in most cases, but with more frequent surveillance, especially for LN.

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Titel: Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)
verfasst von: Christoph J. Rageth
Elizabeth A. M. O’Flynn
Katja Pinker
Rahel A. Kubik-Huch
Alexander Mundinger
Thomas Decker
Christoph Tausch
Florian Dammann
Pascal A. Baltzer
Eva Maria Fallenberg
Maria P. Foschini
Sophie Dellas
Michael Knauer
Caroline Malhaire
Martin Sonnenschein
Andreas Boos
Elisabeth Morris
Zsuzsanna Varga
Publikationsdatum: 30.11.2018
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 2/2019
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-05071-1

Springer Medizin

Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)