Predictive value of needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening

Predictive value of needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening
M E El-Sayed, E A Rakha, J Reed, A H S Lee, A J Evans, I O Ellis
Histopathology 2008, 53, 650–657

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Approximately 20% of needle core biopsy of screen-detected breast lesions classified as B3 are malignant on excision, and the likelihood of malignancy varies substantially between different histological subtypes

Management of lesions of uncertain malignant potential on breast core needle histology: an alternative to surgery in selected cases

Management of lesions of uncertain malignant potential on breast core needle histology: an alternative to surgery in selected cases
S.L. Tennant, A. Evans, L.J. Hamilton, J. James, A.H.S. Lee, Z. Hodi, I.O. Ellis, E.A. Rakha, A.R.M. Wilson
The Breast 17 (2008) 546–549

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Something we all aspire to do - not overtreat borderline lesions which could possibly be followed, after adequate Vacuum Assisted Biopsy. This is a sensible way to go, with adequate multidiscipinary discussion of the case, and close follow up

Management of lesions of uncertain malignant potential on breast core needle histology: Vacuum-assisted excision as an alternative to surgical excisio

Management of lesions of uncertain malignant potential on breast core needle histology: Vacuum-assisted excision as an alternative to surgical excision (EDITORIAL)
The Breast 17 (2008) 543–544

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Editorial comment on the Nottingham paper

Borderline breast lesions diagnosed at core needle biopsy: Can magnetic resonance mammography rule out associated malignancy? Preliminary results base

Anna Linda, Chiara Zuiani, Massimo Bazzocchi, Alessandro Furlan and Viviana Londero
The Breast 17, 2, April 2008, Pages 125-131

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The purpose of this study is to assess whether magnetic resonance mammography (MRM) can exclude associated malignancy in case of diagnosis of borderline breast lesions (B3) at core needle biopsy (CNB). Retrospective analysis of MRM findings of 79 borderline breast lesions (26 benign papillomas, 29 radial sclerosing lesions, 6 atypical ductal hyperplasias, 18 lobular neoplasias) diagnosed at CNB was performed.

Lesions were classified as “non-suspicious” or “suspicious” according to Fischer score. These findings were compared to the results of histological analysis of the excisional specimens. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of MRM in predicting the presence of malignancy were calculated. Out of 24 (30.4%) lesions classified as “suspicious”, 8 (33.3%) proved to be malignant and 16 (66.7%) benign. Among the 55 (69.6%) “non-suspicious” lesions, only 1 (1.8%) was malignant (low-grade ductal carcinoma in situ), while the remaining 54 (98.2%) proved to be benign. MRM sensitivity, specificity, PPV, and NPV were 88.9%, 77.1%, 33.3%, and 98.2%, respectively.

When a borderline lesion is diagnosed on CNB, in case of mild or no enhancement at MRM, follow-up rather than excisional biopsy might be prompted.