Three-year Trends in Diagnosis of B3 Breast Lesions and Their Upgrade Rates to Malignant Lesions

Griffiths, R.; Kaur, Charanjit; Alarcon, Lida; Szöllősi, Zoltán

doi:10.1016/j.clbc.2019.12.009

Cited by 7 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, the overall upgrade rate to malignancy for B3 lesions was 26.4% for BreastScreen NSW, Australia. This is consistent with the upgrade rates reported in the literature which ranged from 10 to 35% [ [ 6 , [11] , [12] , [13] , [14] ]]. The majority of the B3 lesions were upgraded to DCIS (69.2%) instead of invasive cancers (29.6%) and a much smaller proportion to malignant phyllodes (1.0%), similar to results in the literature [ [ 11 , 12 , 14 ]].…”

Section: Discussionsupporting

confidence: 91%

“…Some studies have suggested subdividing B3 lesions into those with atypia and those without given the difference in upgrade rates to malignancy between lesions with and without atypia on needle biopsy. B3 lesions with features of atypia are advised to be excised whilst those without could be managed via close surveillance and avoid excision in the first instance [ [ 8 , 13 ]].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of atypical (B3) core biopsy lesions diagnosed across BreastScreen NSW, Australia

Chou,

Tran,

Descallar

et al. 2024

The Breast

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Outcomes of atypical (B3) core biopsy lesions diagnosed across BreastScreen NSW, Australia

Chou,

Tran,

Descallar

et al. 2024

The Breast

View full text Add to dashboard Cite

“…In fact, it not only reduces the likelihood of overdiagnosing cases with predominant benign features but with some worrisome cytological alterations but also limits the occurrence of false‐negative rates 33 . Interestingly, the corresponding diagnostic category adopted in CNB to classify histological lesions with uncertain malignant potential (B3) is upgraded to malignancy in up to 35% of cases upon surgical excision and is associated with a ROM of 21.2%, a percentage very similar to that observed in the atypical category 32,34,35 …”

Section: Discussionmentioning

confidence: 94%

“…histological lesions with uncertain malignant potential (B3) is upgraded to malignancy in up to 35% of cases upon surgical excision and is associated with a ROM of 21.2%, a percentage very similar to that observed in the atypical category. 32,34,35 In this study, the three in-situ lesions (two DCIS and one IPC)…”

Section: Adenomyoepitheliomamentioning

confidence: 99%

The continuing role of breast fine‐needle aspiration biopsy after the introduction of the IAC Yokohama System For Reporting Breast Fine Needle Aspiration Biopsy Cytopathology

Rosa

Migliatico

Vigliar

et al. 2020

Diagnostic Cytopathology

View full text Add to dashboard Cite

Background: Ultrasound-guided fine-needle aspiration biopsy (FNAB) (US-guided FNAB) is a rapid and cost-effective procedure for the diagnosis of breast lesions. Our Institution has a long tradition in breast FNAB performed by cytopathologists; recently we adopted both US guidance and a five-tiered classification system similar to that proposed by the International Academy of Cytology (IAC). The aim of this study was to demonstrate the continuing role of US-guided FNAB in the diagnosis of breast lesions, despite the growing adoption of core-needle biopsy (CNB). Methods: The laboratory information database system was searched to obtain the breast FNAB diagnostic reports recorded from 2010 to 2017 and classified using a five-tiered Classification System; each entry was matched with the available histology. Results: A total of 4624 breast FNAB samples were retrieved. Of these, 1745/4624 cases (37.7%) had histological follow-ups. The risk of malignancy (ROM) was 4.9% for benign, 20.7% for atypical, 78.7% for suspicious of malignancy, and 98.8% for malignant. When the atypical category was evaluated as a negative index, the positive predictive value was 93.73%, and the negative predictive value was 90.78%, reaching an overall diagnostic accuracy of 92.82%. Conclusions: The IAC Yokohama System for Reporting Breast FNAB Cytopathology clearly identifies different diagnostic categories with increasing ROM. Most of the FNAB samples were classified as benign or malignant (65.3%), warranting prompt management for these patients. Moreover, the inclusion of the atypical category as a low-risk indeterminate category avoided overtreatment of benign lesions. Thus, despite the well-established merits of CNB, US-guided FNAB still represents a costeffective and rapid nonoperative diagnostic approach.

show abstract

“…ADH and papillary lesions with atypia) in our cohort was comparable to other international studies. 3,8,9,[12][13][14][15][16][17][18][19][20] Given the consistency of high upgrade rates, we believe standard open surgical excisional biopsy should be performed for ADH and papillary lesions with atypia.…”

Section: Discussionmentioning

confidence: 99%

B3 lesion upgrade rates in a tertiary Australian breast centre: a 8‐year experience (2012–2019)

Huang

Park

McLaren

et al. 2020

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: B3 breast lesions identified on core needle biopsy have uncertain malignant potential. Traditional management of these lesions has been surgical excision, but there is growing interest in less invasive and more cost-effective alternatives such as vacuumassisted excisional biopsy (VAEB). Determining the rate of malignant upgrade for B3 lesions is important as it may identify low-risk lesions where VAEB could be considered. Methods: A retrospective study was conducted of women undergoing an elective excisional biopsy for a B3 lesion identified on core needle biopsy at a tertiary Australian breast centre. The pre-operative biopsy diagnosis and subsequent excisional biopsy diagnosis were used to calculate the proportion of cases where the diagnosis was upgraded to malignancy. Results: A total of 299 eligible patients were identified. Pre-operative diagnosis of papillary lesion with atypia was associated with the highest upgrade rate (50%, n = 12). The next highest upgrade rates occurred in those with flat epithelial atypia (37.50%, n = 8); atypical ductal hyperplasia (24.71%, n = 85); lobular carcinoma in situ (LCIS)/atypical lobular hyperplasia with calcification (17.65%, n = 17); and papillary lesion without atypia (4.72%, n = 106). Patients with radial scar (n = 51), classical LCIS without calcification (n = 7) and mucocoele-like lesion (n = 8) had a 0% upgrade rate. Conclusion: VAEB may be appropriate for low malignant risk lesions such as papillary lesion without atypia, mucocoele-like lesion and radial scar lesion without atypia. Opensurgical-excisional biopsy remains appropriate for high upgrade lesions such as atypical ductal hyperplasia, papillary lesion with atypia, flat epithelial atypia and classical LCIS with calcification. Long-term prospective randomized multicentre studies and continuing multidisciplinary approach is recommended for future clinical implementation.

show abstract

Three-year Trends in Diagnosis of B3 Breast Lesions and Their Upgrade Rates to Malignant Lesions

Cited by 7 publications

References 13 publications

Outcomes of atypical (B3) core biopsy lesions diagnosed across BreastScreen NSW, Australia

Outcomes of atypical (B3) core biopsy lesions diagnosed across BreastScreen NSW, Australia

The continuing role of breast fine‐needle aspiration biopsy after the introduction of the IAC Yokohama System For Reporting Breast Fine Needle Aspiration Biopsy Cytopathology

B3 lesion upgrade rates in a tertiary Australian breast centre: a 8‐year experience (2012–2019)

Contact Info

Product

Resources

About