Breast core biopsy reporting categories—An internal validation in a series of 3054 consecutive lesions

Andreu, Francisco Javier; Sáez, Amparo; Sentís, Melcior; Rey, M.; Fernández, Sara; Dinarès, Carme; Tortajada, Lidia; Ganau, Sergi; Palomar, Glòria

doi:10.1016/j.breast.2006.06.009

Cited by 32 publications

(23 citation statements)

References 38 publications

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“…In this series B3 biopsies accounted for 7.7% of all NCBs performed over a 9-year period, in keeping with rates from other units (3–9.2%) 6 7 8 9. Sixteen per cent proved malignant on excision; this is slightly lower than the 20% reported by El-Sayed et al in their series of 523 patients 10.…”

Section: Discussionsupporting

confidence: 81%

Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience

2009

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Section: Discussionsupporting

confidence: 81%

Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience

2009

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“…According to the current system of NCB categorization, 5 a diversity of lesions can result in borderline categories: lesion of uncertain malignant potential (B3) or suspicious of malignancy (B4). Previous studies have reported PPVs for B3 lesions from 20% to 35% and PPVs for B4 lesions from 83% to 90% 7,9,12,14–17 . In a previous study of screen‐detected B3 lesions, we noted a reduction in the PPV in recent years 2 .…”

Section: Discussionsupporting

confidence: 48%

Outcome of breast lesions diagnosed as lesion of uncertain malignant potential (B3) or suspicious of malignancy (B4) on needle core biopsy, including detailed review of epithelial atypia

Rakha¹,

Ho²,

Naik³

et al. 2011

Histopathology

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“…The B3 category consists of a heterogeneous group of lesions which may yield only benign histology on initial NCB sampling but are recognized to show heterogeneity and may harbor malignancy elsewhere or to have an increased risk of associated adjacent malignancy. 5,6 Although the B3 category constitutes a relatively small proportion of all NCB (3-9%; average 6% 4,[7][8][9][10][11][12] ), most cases progress to surgical intervention to establish an excision histology diagnosis. This has significant implications particularly in screen-detected (nonsymptomatic) breast lesions in which final benign diagnoses after surgical intervention is a drawback of mammographic screening.…”

mentioning

confidence: 99%

Characterization and outcome of breast needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening

Rakha

Lee

Jenkins

et al. 2011

Intl Journal of Cancer

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In the setting of breast cancer screening, 5-9% of needle core biopsies are diagnosed as lesions of uncertain malignant potential (B3). The management of these lesions is potentially problematic as the data on their outcome remains limited. In our study, we aim to assess the outcome of screen-detected lesions diagnosed as B3 in a large series to validate previous studies and to characterize the malignant lesions detected after a B3 diagnosis. Therefore, the results of 1,025 needle core biopsies of women screened over a 7-year period (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006) in two different regions in the UK with B3 diagnoses who underwent surgical excision were reviewed and compared to the final excision histology. Final histology showed that 25% of cases were malignant (17% ductal carcinoma in situ and 8% invasive). Predictors of malignancy included calcification on imaging and epithelial atypia on needle core biopsy particularly atypical ductal hyperplasia [positive predictive value 50%]. Pure flat epithelial atypia showed the lowest positive predictive value amongst all epithelial atypia groups (21%). The positive predictive value was low for complex sclerosing lesions (9%) and papillary lesions (13%) without epithelial atypia. Malignant tumors detected after B3 diagnosis showed favorable histological features, the majority were in situ, and most belonged to the low grade breast neoplasia family that is associated with indolent behavior. The underlying radiological abnormality was calcification in 44% of cases and the imaging classification was malignant/suspicious in 38%. In conclusion, our results further emphasize the heterogeneity of B3 lesions and that the likelihood of malignancy varies substantially between different histological subtypes. Malignancy is particularly associated with epithelial atypia suggesting the use of two categories of with and without epithelial atypia. Radiological findings provided useful information regarding the nature and outcome of B3 lesions.

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Breast core biopsy reporting categories—An internal validation in a series of 3054 consecutive lesions

Cited by 32 publications

References 38 publications

Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience

Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience

Outcome of breast lesions diagnosed as lesion of uncertain malignant potential (B3) or suspicious of malignancy (B4) on needle core biopsy, including detailed review of epithelial atypia

Characterization and outcome of breast needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening

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