Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?
Abstract 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 o...
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doaj-c4db0a637dae4aa99b61aa9ed01e0a362020-11-25T01:21:25ZengBMCBMC Medical Imaging1471-23422018-09-011811810.1186/s12880-018-0271-7Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?H. Preibsch0L. K. Wanner1A. Staebler2M. Hahn3K. C. Siegmann-Luz4Department of Diagnostic and Interventional Radiology, University Hospital TuebingenDepartment of Diagnostic and Interventional Radiology, University Hospital TuebingenDepartment of Pathology and Neuropathology, University Hospital TuebingenDepartment of Obstetrics and Gynecology, University Hospital TuebingenDiagnostic Breast Centre and Breast Cancer Screening Brandenburg EastAbstract 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.http://link.springer.com/article/10.1186/s12880-018-0271-7B3 lesionsVacuum-assisted biopsyBreast MRIMRI-guided breast biopsy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
H. Preibsch L. K. Wanner A. Staebler M. Hahn K. C. Siegmann-Luz |
spellingShingle |
H. Preibsch L. K. Wanner A. Staebler M. Hahn K. C. Siegmann-Luz Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised? BMC Medical Imaging B3 lesions Vacuum-assisted biopsy Breast MRI MRI-guided breast biopsy |
author_facet |
H. Preibsch L. K. Wanner A. Staebler M. Hahn K. C. Siegmann-Luz |
author_sort |
H. Preibsch |
title |
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_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_sort |
malignancy rates of b3-lesions in breast magnetic resonance imaging – do all lesions have to be excised? |
publisher |
BMC |
series |
BMC Medical Imaging |
issn |
1471-2342 |
publishDate |
2018-09-01 |
description |
Abstract 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. |
topic |
B3 lesions Vacuum-assisted biopsy Breast MRI MRI-guided breast biopsy |
url |
http://link.springer.com/article/10.1186/s12880-018-0271-7 |
work_keys_str_mv |
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