Outcome of a new patient pathway for managing B3 breast lesions by vacuum-assisted biopsy: time to change current UK practice?

Strachan, CL; Horgan, Kieran; Millican-Slater, Rebecca; Shaaban, Abeer M.; Sharma, Nisha

doi:10.1136/jclinpath-2015-203018

Cited by 42 publications

(41 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[10][11][12] When an indeterminate lesion is found on a diagnostic core biopsy, further evaluation is warranted to exclude a diagnosis of coexisting invasive or non-invasive malignancy. In some cases, pathologists prefer the lesion to be removed whole rather than piecemeal.…”

Section: Diagnosis Of Indeterminate Lesionsmentioning

confidence: 99%

“…Rates of underestimation were more frequent with B3 lesions with atypia than those without. 10,11 Four studies and one meta-analysis have focused on upgrade rates of B3 lesions diagnosed on core biopsy found to have malignant disease at surgery. Bianchi These studies highlight that B3 lesions are predominantly upgraded to DCIS and less frequently upgraded to invasive tumour.…”

Section: Upgrade Rate Of B3 Lesionsmentioning

confidence: 99%

“…As the use of VAE increases, pathways are being developed where VAE is used as an alternative. 10 At present, this has been applied only in a minority of centres in the UK and is predominantly directed towards the lowrisk B3 lesions without epithelial atypia. The NHS BSP has defined targets in order to minimize the number of diagnostic open surgical biopsies.…”

Section: Vacuum-assisted Excision Vs Surgical Biopsy In Breast Screeningmentioning

confidence: 99%

“…This highlights the need to improve the pre-operative diagnosis of malignancy within the B3 cohort, which can be performed by adopting VAE for all B3 lesions (except papillary lesions with atypia and fibroepithelial lesions) particularly those with epithelial atypia. Strachan et al 10 have demonstrated that adopting VAE as a secondline management of B3 lesions prevents unnecessary surgery. They showed that improved pre-operative diagnosis by VAE prevented 62% (245 females) from having a surgical biopsy and identified a further 43 cases of malignancy pre-operatively that would have been otherwise detected at surgery.…”

Section: Vacuum-assisted Excision Vs Surgical Biopsy In Breast Screeningmentioning

confidence: 99%

“…There are a handful of articles that have shown that the upgrade is mainly to non-invasive cancers and a smaller number are low-grade invasive tumours. In the literature, the majority of the associated cancers have been identified at surgical biopsy, but Strachan et al 10 have shown an improved preoperative diagnosis of malignancy using VAE in the B3 cohort. VAE can be used to identify the cancers pre-operatively.…”

Section: Future Management Of B3 Lesionsmentioning

confidence: 99%

See 4 more Smart Citations

The B3 conundrum—the radiologists' perspective

Sharma¹,

Wilkinson

Pinder

2017

The British Journal of Radiology

View full text Add to dashboard Cite

The management of B3 lesions is both controversial and complicated. There have been recent publications regarding how best to manage this heterogeneous group particularly in light of the Marmot Review and with the advent of vacuumassisted biopsy technique. It is recognized that B3 lesions on core biopsy can be upgraded to malignancy in up to onethird of cases, but this is predominantly to ductal carcinoma in situ or low-grade invasive tumours. The upgrade rate is mainly associated with B3 lesions with epithelial atypia. This review summarizes the current management and focuses on the proposed future management of these B3 lesions.

show abstract

Section: Diagnosis Of Indeterminate Lesionsmentioning

confidence: 99%

Section: Upgrade Rate Of B3 Lesionsmentioning

confidence: 99%

Section: Vacuum-assisted Excision Vs Surgical Biopsy In Breast Screeningmentioning

confidence: 99%

Section: Vacuum-assisted Excision Vs Surgical Biopsy In Breast Screeningmentioning

confidence: 99%

Section: Future Management Of B3 Lesionsmentioning

confidence: 99%

See 3 more Smart Citations

The B3 conundrum—the radiologists' perspective

Sharma¹,

Wilkinson

Pinder

2017

The British Journal of Radiology

View full text Add to dashboard Cite

show abstract

Australian breast surgeons and ultrasound usage: Have practices changed?

Bennett

Khoo

Viana³

et al. 2021

Australas J Ultrason Med

View full text Add to dashboard Cite

Background A recent survey of surgeon performed ultrasound usage was conducted amongst registered members of the Breast Surgeons of Australia and New Zealand Society (BreastSurgANZ) and was compared with a previous survey undertaken in 2010 to determine whether patterns of utilization had changed. Methods From July to September 2019, members of BreastSurgANZ were invited to complete an electronic online survey of personal usage of breast ultrasound focusing on ultrasound equipment access, use of office and intraoperative ultrasound, biopsy interventions and training expectations. Results There were 73 respondents to the survey with 45 (61.6%) members indicating access to ultrasound within their practices. Whilst current regular ultrasound usage (68.1%) was only slightly greater than in 2010 (66%), the proportion of respondents not performing any form of needle intervention had increased (62.5% compared to 53% in 2010) and with the proportion of surgeons currently performing >10 biopsies per month decreasing from 10% to only 5.56%. However the percentage of surgeons utilizing intraoperative ultrasound had notably increased since 2010 with 49.3% currently using ultrasound in the operating room compared with only 17% previously. The majority of respondents believed that breast ultrasound training should be conducted through BreastSurgANZ post fellowship training programs. Conclusion The overall utilization of surgeon‐performed ultrasound amongst BreastSurgANZ members has remained similar over the past 9 years with the performance of needle interventions declining slightly, but with the application of intraoperative ultrasound having increased. An ultrasound training curriculum as part of the BreastSurgANZ post fellowship training program is a necessary imperative.

show abstract

Lobular Neoplasia

Shaaban¹

2016

Breast Pathology

View full text Add to dashboard Cite

Outcome of a new patient pathway for managing B3 breast lesions by vacuum-assisted biopsy: time to change current UK practice?

Abstract: We have demonstrated here that with large volume tissue sampling for indeterminate lesions of the breast surgery can be safely avoided in selected B3 lesions with and without atypia.

Cited by 42 publications

References 12 publications

The B3 conundrum—the radiologists' perspective

The B3 conundrum—the radiologists' perspective

Australian breast surgeons and ultrasound usage: Have practices changed?

Lobular Neoplasia

Contact Info

Product

Resources

About