B3-lesions of the breast and cancer risk - an analysis of mammography screening patients.
The use of mammography screening, followed by needle core biopsy (NCB), is associated with an increasing amount of invasive procedures. A considerable amount of specimens must be classified as lesions with uncertain malignant potential (B3-lesion). In these cases, an open biopsy is indicated for further diagnosis. We evaluated patients with B3-lesions to determine the risk of malignancy corresponding to the histopathological NCB results and the type of radiological lesion identified. A total of 95 patients participating in the German mammography screening program with a B3-lesion following NCB (104 B3-lesions in total) were included in our analysis. We analyzed the correlation between the initial histopathological findings from the NCB specimen and cancer risk. We further analyzed the correlations of malignant results with the type of mammographic lesion. In 23 cases (22%), histopathological examination following excision revealed a malignant lesion, including invasive andin situcarcinoma. The positive predictive value of the subgroups of B3-lesions ranged between 0.11 and 0.31; the B3-lesion associated with the highest cancer risk was the atypical ductal hyperplasia; however, no significant difference was observed between the B3-lesion subgroups (P=0.309) regarding the risk of malignancy. Comparing the different types of mammographic findings, such as radiological mass or microcalcifications, there was no significant difference in the risk for malignancy (P=0.379). The different types of B3-lesions did not exhibit differences in the risk for malignancy, and the morphological type of mammographic lesion does not appear to be correlated with cancer risk; therefore, our results underline the need for open biopsy in patients with B3-lesions following NCB.
Department of Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, D-45122 Essen, Germany.
Oliver
O
Hoffmann
Department of Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, D-45122 Essen, Germany; Intensive Care Unit (Critical Care Complex), North Middlesex University Hospital, London N181QX, UK.
Gesina Athina
GA
Stamatis
Department of Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, D-45122 Essen, Germany.
Ann-Kathrin
AK
Bittner
Center of Pathology Essen-Mitte, D-45276 Essen, Germany.
Georg
G
Arnold
Department of Pathology Essen-Steele, D-45276 Essen, Germany.
Rolf
R
Schnabel
Diavero Breast Diagnosis Center, D-45257 Essen, Germany.
Karlgeorg
K
Krüger
Department of Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, D-45122 Essen, Germany.
Rainer
R
Kimmig
Department of Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, D-45122 Essen, Germany.
Martin
M
Heubner
B-coding system; B3-lesion; breast cancer; mammography screening; needle core biopsy; open biopsy