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

Abstract

This issue of the journal continues the important debate on how best to manage lesions categorised as B3, or lesions of uncertain malignant potential, diagnosed by core needle biopsy (CNB). Approximately 25–30% of these lesions are found to be malignant on excision histology, 1 Lee A.H.S. Denley H.E. Pinder S.E. Ellis I.O. Elston C.W. Vujovic P. et al. Excision biopsy findings of patients with breast needle core biopsies reported as suspicious of malignancy (B4) or lesion of uncertain malignant potential (B3). Histopathology. 2003; 42: 331-336 Crossref PubMed Scopus (92) Google Scholar , 2 Houssami N. Ciatto S. Bilous M. Vezzosi V. Bianchi S. Borderline breast core needle histology: predictive values for malignancy in lesions of uncertain malignant potential (B3). Br J Cancer. 2007; 96: 1253-1257 Crossref PubMed Scopus (105) Google Scholar hence surgical removal has been the primary approach to the management of these B3 lesions following CNB. In a previous issue of The Breast, Linda and colleagues 3 Linda A. Zuiani C. Bazzocchi M. Furlan A. Londero V. Borderline breast lesions diagnosed at core needle biopsy: can magnetic resonance mammography rule out associated malignancy? Preliminary results based on 79 surgically excised lesions. The Breast. 2008; 17: 125-131 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar suggested a role for MRI in the assessment of these lesions, while the present issue includes an evaluation by Tennant and colleagues of large gauge vacuum-assisted core excision (VAE) of selected B3 lesions. 4 Tennant S.L. Evans A. Hamilton L.J. James J. Lee A.H.S. Hodi Z. et al. Vacuumassisted excision of breast lesions of uncertain malignant potential (B3) an alternative to surgery in selected cases. The Breast. 2008; 17: 546-549 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar