External Validation of a Risk Stratification Score for B3 Breast Lesions Detected at Ultrasound Core Needle Biopsy

Grippo, Cristina; Jagmohan, Pooja; Clauser, Paola; Kapetas, Panagiotis; Meier, Arthur; Stöger, Annabel M; D’Angelo, Anna; Baltzer, Pascal

doi:10.3390/diagnostics10040181

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…It is noteworthy that the more underrated B3 subtypes for malignancies were PL/ADH 50% (1/2), ADH 23.1% (3/13), and CSL/RS 16.7% (1/6). The results are in line with the reports [24,25]. Although the malignancy underestimation rate of B3 is limited, multidisciplinary communication and imaging follow-up are necessary so as not to miss malignant potential [26].…”

Section: Study Population Descriptionsupporting

confidence: 89%

Breast lesions excised via Vacuum-Assisted System: Could We Get Any Clues for B3 Lesions Before Excision Biopsy?

Zheng

Xing

et al. 2021

Preprint

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Background: The purpose of this study was to determine the validity of the ultrasound features as well as patient characteristics assigned to B3 (uncertain malignant potential) breast lesions before vacuum-assisted excision biopsy (VAEB).Methods: This study population consisted of 2245 women with breast-nodular abnormalities, which were conducted ultrasound-guided VAEB (US-VAEB). Patient’s clinical and anamnestic data and lesion-related ultrasonic feature variables of B3 were compared with those of benign or malignant cases, using histopathological results as a benchmark. Results: The proportions of benign, B3 and malignant breast lesions were 88.5%, 8.2% and 3.4% respectively. B3 high frequent occurred in BI-RADS-US grade 3 (7.7%), grade 4 (9.3%), grade 4a (11.3%) and grade 4b (9.1%). The overall malignancy underestimation rate of B3 cases was 4.4% (8/183). The more common malignancy underestimation of B3 subtypes were PL/ADH 50% (1/2), ADH 23.1% (3/13), and CSL/RS 16.7% (1/6). And the highly frequent recurrence rates of B3 subtypes were ADH 10% (1/10), PL 4.9% (4/82), and PT 8.6% (6/70). Multivariate binary logistic regression analyses (B3 vs benign) showed that non-menopausal patients (95% CI 1.628-8.616, P = 0.002), single (95% CI 1.370-2.650, P = 0.000) or abundant blood supply (95% CI 1.745-4.150, P = 0.000) nodules via ultrasound examination were significant risk factors for B3 occurrences. Moreover, patients elder than 50 years (95% CI 3.178-19.816, P = 0.000), unclear margin (95% CI 3.571-14.119, P = 0.000) or microcalcification (95% CI 4.010-30.733, P = 0.000) nodules were significantly associated with higher risks of malignant potentials (B3 vs malignant).Conclusion: The results of this study indicate that ultrasound findings and patients’ characteristics could provide valuable information for distinguishing B3 cases from benign or malignant cases before VAEB.

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Section: Study Population Descriptionsupporting

confidence: 89%

Breast lesions excised via Vacuum-Assisted System: Could We Get Any Clues for B3 Lesions Before Excision Biopsy?

Zheng

Xing

et al. 2021

Preprint

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“…Of note, the differential diagnosis between ADH and low-grade DCIS is based only on lesion size. As such, ADH cannot be definitively diagnosed over low-grade DCIS at percutaneous biopsy, as the biopsied sample may belong to a larger low-grade DCIS lesion that was not entirely sampled; instead, some authors recommend use the term AIDEP to describe findings indicating ADH or low-grade DCIS at percutaneous biopsy [ 6 , 10 , 19 ].…”

Section: Atypical Ductal Hyperplasiamentioning

confidence: 99%

High-risk lesions of the breast: concurrent diagnostic tools and management recommendations

et al. 2021

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Breast lesions with uncertain malignant behavior, also known as high-risk or B3 lesions, are composed of a variety of pathologies with differing risks of associated malignancy. While open excision was previously preferred to manage all high-risk lesions, tailored management has been increasingly favored to reduce overtreatment and spare patients from unnecessary anxiety or high healthcare costs associated with surgical excision. The purpose of this work is to provide the reader with an accurate overview focused on the main high-risk lesions of the breast: atypical intraductal epithelial proliferation (atypical ductal hyperplasia), lobular neoplasia (including the subcategories lobular carcinoma in situ and atypical lobular hyperplasia), flat epithelial atypia, radial scar and papillary lesions, and phyllodes tumor. Beyond merely presenting the radiological aspects of these lesions and the recent literature, information about their potential upgrade rates is discussed in order to provide a useful guide for appropriate clinical management while avoiding the risks of unnecessary surgical intervention (overtreatment).

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“…Grippo et al [ 69 ] recently evaluated its feasibility based on clinical, pathological, and radiological data. It is assumed that a RS lesion with associated atypia should undergo therapeutic excision with VAB.…”

Section: Managementmentioning

confidence: 99%

Radial Scar: a management dilemma

et al. 2021

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Radial scar (RS) or complex sclerosing lesions (CSL) if > 10 mm is a benign lesion with an increasing incidence of diagnosis (ranging from 0.6 to 3.7%) and represents a challenge both for radiologists and for pathologists. The digital mammography and digital breast tomosynthesis appearances of RS are well documented, according to the literature. On ultrasound, variable aspects can be detected. Magnetic resonance imaging contribution to differential diagnosis with carcinoma is growing. As for the management, a vacuum-assisted biopsy (VAB) with large core is recommended after a percutaneous diagnosis of RS due to potential sampling error. According to the recent International Consensus Conference, a RS/CSL lesion, which is visible on imaging, should undergo therapeutic excision with VAB. Thereafter, surveillance is justified. The aim of this review is to provide a practical guide for the recognition of RS on imaging, illustrating radiological findings according to the most recent literature, and to delineate the management strategies that follow.

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External Validation of a Risk Stratification Score for B3 Breast Lesions Detected at Ultrasound Core Needle Biopsy

Cited by 5 publications

References 26 publications

Breast lesions excised via Vacuum-Assisted System: Could We Get Any Clues for B3 Lesions Before Excision Biopsy?

Breast lesions excised via Vacuum-Assisted System: Could We Get Any Clues for B3 Lesions Before Excision Biopsy?

High-risk lesions of the breast: concurrent diagnostic tools and management recommendations

Radial Scar: a management dilemma

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