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Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?

BACKGROUND: Approximately 10% of all MRI-guided vacuum-assisted breast biopsies (MR-VAB) are histologically classified as B3 lesions. In most of these cases surgical excision is recommended. The aim of our study was to evaluate the malignancy rates of different B3 lesions which are visible on MRI to...

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Autores principales: Preibsch, H., Wanner, L. K., Staebler, A., Hahn, M., Siegmann-Luz, K. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131767/
https://www.ncbi.nlm.nih.gov/pubmed/30200900
http://dx.doi.org/10.1186/s12880-018-0271-7
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author Preibsch, H.
Wanner, L. K.
Staebler, A.
Hahn, M.
Siegmann-Luz, K. C.
author_facet Preibsch, H.
Wanner, L. K.
Staebler, A.
Hahn, M.
Siegmann-Luz, K. C.
author_sort Preibsch, H.
collection PubMed
description BACKGROUND: Approximately 10% of all MRI-guided vacuum-assisted breast biopsies (MR-VAB) are histologically classified as B3 lesions. In most of these cases surgical excision is recommended. The aim of our study was to evaluate the malignancy rates of different B3 lesions which are visible on MRI to allow a lesion-adapted recommendation of further procedure. METHODS: Retrospective analysis of 572 consecutive MR-VAB was performed. Inclusion criteria were a representative (=successful) MR-VAB, histologic diagnosis of a B3 lesion and either the existence of a definite histology after surgical excision or proof of stability or regression of the lesion on follow-up MRI. Malignancy rates were evaluated for different histologies of B3 lesions. Lesion size and lesion morphology (mass/non-mass enhancement) on MRI were correlated with malignancy. RESULTS: Of all MR-VAB 43 lesions fulfilled the inclusion criteria. The malignancy rate of those B3 lesions was 23.3% (10/43). The highest malignancy rate was found in atypical ductal hyperplasia (ADH) lesions (50.0%; 4/8), 33.3% (2/6) in flat epithelial atypia (FEA), 28.6% (2/7) in lobular intraepithelial neoplasia (LIN) and 12.5% (2/16) in papillary lesions (PL). All 6 complex sclerosing lesions were benign. Mass findings were significantly more frequently malignant (31.3%, 10/32; p < 0.05) than non-mass findings (0/11). Small lesions measuring 5–10 mm were most often malignant (35.0%; 7/20). All large lesions (> 20 mm) were not malignant (0/10). Intermediate sized lesions (11–20 mm) turned out to be malignant in 23.1% (3/13). CONCLUSIONS: The malignancy rate of B3 lesions which were diagnosed after MR-VAB was 23.3%. ADH, FEA and LIN showed considerable malignancy rates (50%, 33% and 29%) and should therefore undergo surgical excision. None of the cases, which were diagnosed as radial scars, non-mass enhancement or larger lesions (> 20 mm) were malignant. Here, a follow-up MRI seems to be advisable to avoid unnecessary operations. TRIAL REGISTRATION: Retrospective study design, waived by the IRB.
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spelling pubmed-61317672018-09-13 Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised? Preibsch, H. Wanner, L. K. Staebler, A. Hahn, M. Siegmann-Luz, K. C. BMC Med Imaging Research Article BACKGROUND: Approximately 10% of all MRI-guided vacuum-assisted breast biopsies (MR-VAB) are histologically classified as B3 lesions. In most of these cases surgical excision is recommended. The aim of our study was to evaluate the malignancy rates of different B3 lesions which are visible on MRI to allow a lesion-adapted recommendation of further procedure. METHODS: Retrospective analysis of 572 consecutive MR-VAB was performed. Inclusion criteria were a representative (=successful) MR-VAB, histologic diagnosis of a B3 lesion and either the existence of a definite histology after surgical excision or proof of stability or regression of the lesion on follow-up MRI. Malignancy rates were evaluated for different histologies of B3 lesions. Lesion size and lesion morphology (mass/non-mass enhancement) on MRI were correlated with malignancy. RESULTS: Of all MR-VAB 43 lesions fulfilled the inclusion criteria. The malignancy rate of those B3 lesions was 23.3% (10/43). The highest malignancy rate was found in atypical ductal hyperplasia (ADH) lesions (50.0%; 4/8), 33.3% (2/6) in flat epithelial atypia (FEA), 28.6% (2/7) in lobular intraepithelial neoplasia (LIN) and 12.5% (2/16) in papillary lesions (PL). All 6 complex sclerosing lesions were benign. Mass findings were significantly more frequently malignant (31.3%, 10/32; p < 0.05) than non-mass findings (0/11). Small lesions measuring 5–10 mm were most often malignant (35.0%; 7/20). All large lesions (> 20 mm) were not malignant (0/10). Intermediate sized lesions (11–20 mm) turned out to be malignant in 23.1% (3/13). CONCLUSIONS: The malignancy rate of B3 lesions which were diagnosed after MR-VAB was 23.3%. ADH, FEA and LIN showed considerable malignancy rates (50%, 33% and 29%) and should therefore undergo surgical excision. None of the cases, which were diagnosed as radial scars, non-mass enhancement or larger lesions (> 20 mm) were malignant. Here, a follow-up MRI seems to be advisable to avoid unnecessary operations. TRIAL REGISTRATION: Retrospective study design, waived by the IRB. BioMed Central 2018-09-10 /pmc/articles/PMC6131767/ /pubmed/30200900 http://dx.doi.org/10.1186/s12880-018-0271-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Preibsch, H.
Wanner, L. K.
Staebler, A.
Hahn, M.
Siegmann-Luz, K. C.
Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
title Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
title_full Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
title_fullStr Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
title_full_unstemmed Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
title_short Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
title_sort malignancy rates of b3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131767/
https://www.ncbi.nlm.nih.gov/pubmed/30200900
http://dx.doi.org/10.1186/s12880-018-0271-7
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