Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) Review

   


Authors: Rageth, C. J.; O’Flynn, E. A. M.; Pinker, K.; Kubik-Huch, R. A.; Mundinger, A.; Decker, T.; Tausch, C.; Dammann, F.; Baltzer, P. A.; Fallenberg, E. M.; Foschini, M. P.; Dellas, S.; Knauer, M.; Malhaire, C.; Sonnenschein, M.; Boos, A.; Morris, E.; Varga, Z.
Review Title: Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)
Abstract: Purpose: The second International Consensus Conference on B3 lesions was held in Zurich, Switzerland, in March 2018, organized by the International Breast Ultrasound School to re-evaluate the consensus recommendations. Methods: This study (1) evaluated how management recommendations of the first Zurich Consensus Conference of 2016 on B3 lesions had influenced daily practice and (2) reviewed current literature towards recommendations to biopsy. Results: In 2018, the consensus recommendations for management of B3 lesions remained almost unchanged: For flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL) and radial scars (RS) diagnosed on core-needle biopsy (CNB) or vacuum-assisted biopsy (VAB), excision by VAB in preference to open surgery, and for atypical ductal hyperplasia (ADH) and phyllodes tumors (PT) diagnosed at VAB or CNB, first-line open surgical excision (OE) with follow-up surveillance imaging for 5 years. Analyzing the Database of the Swiss Minimally Invasive Breast Biopsies (MIBB) with more than 30,000 procedures recorded, there was a significant increase in recommending more frequent surveillance of LN [65% in 2018 vs. 51% in 2016 (p = 0.004)], FEA (72% in 2018 vs. 62% in 2016 (p = 0.005)), and PL [(76% in 2018 vs. 70% in 2016 (p = 0.04)] diagnosed on VAB. A trend to more frequent surveillance was also noted also for RS [77% in 2018 vs. 67% in 2016 (p = 0.07)]. Conclusions: Minimally invasive management of B3 lesions (except ADH and PT) with VAB continues to be appropriate as an alternative to first-line OE in most cases, but with more frequent surveillance, especially for LN. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: controlled study; human tissue; histopathology; review; cancer risk; consensus; breast cancer; breast; phyllodes tumor; risk assessment; needle biopsy; carcinogenicity; biopsy technique; papillary carcinoma; breast surgery; breast lesion; atypical ductal hyperplasia; vacuum-assisted biopsy; uncertain malignant potential; open surgery; human; priority journal; b3 lesions; vacuum assisted biopsy; malignant neoplasm
Journal Title: Breast Cancer Research and Treatment
Volume: 174
Issue: 2
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2019-04-01
Start Page: 279
End Page: 296
Language: English
DOI: 10.1007/s10549-018-05071-1
PUBMED: 30506111
PROVIDER: scopus
PMCID: PMC6538569
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85057967172&doi=10.1007%2fs10549-018-05071-1&partnerID=40&md5=ba758d0cb79b5e934679993a971ecee9
Notes: Correction issued, see DOI: 10.1007/s10549-019-05287-9 -- Review -- Export Date: 1 April 2019 -- Source: Scopus
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MSK Authors
  1. Elizabeth A Morris
    341 Morris
  2. Katja Pinker-Domenig
    215 Pinker-Domenig
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