B3 lesions of the breast encompass a heterogeneous spectrum of abnormalities with variable malignant potential. In light of recent national and international consensus documents [1-3], we conducted a restrospective analysis on the management of B3 lesions of the breast relative to the Breast Unit case series of Trieste, Italy, in the period 2006-2016. The aim of this study is to determine their prevalence and the risk of malignancy correlated to different histologic subtypes and mammographic findings, in order improve evidence based appropriate management.

B3 lesions identified by NCB (Needle Core Biopsy) and/or VAB (Vaacum-Assisted core biopsy)were classified in different histologic subtypesaccording to literature [4]: atypical ductal hyperplasia (ADH), papillary lesions (PL), lobular intraepithelial neoplasia grade 1 and 2 (LIN 1-2), flat epithelial atypia (FEA), radial scar/complex sclerosing lesions (RS/CLS), fibroepithelial lesions (phyllodes tumor and fibroadenoma) and atypical nonspecific -not classifiable B3 lesions. Histopathological results from NCB and/or VAB were compared with postsurgical histopathological findings, calculating the positive predictive value (PPV) for malignancy (relative to all B3 lesions and...

From 2006 to 2016, among 10200 breast lesions examined with a cytological and micro-histological approach, we identified 197 B3 lesions (1.9%) in 196 women (age 56±13 years) (Fig. 1). Papillary lesions represented the predominant histologic subtype (29.4%) (Fig. 2). 112 B3 lesions (57%) underwent excisional biopsy, with an upgrade rate of 19% and a PPV of 11%, while 85 B3 lesions (43%) were sent to follow-up. The B3 lesions investigated with the first cytological approach (63%) were more frequently submitted to surgical biopsy than the...

In the study period we reported a lower prevalence (1.9%) and a lower PPV (11%) of B3 lesions, as compared with literature (4-9% and 25-30% respectively) [3,5-8]. This is explained by the fact that in the Breast Unit of Trieste the majority of breast lesions (87%) is resolved by cytology examination alone (vs 54% of other centers reported experiences) [3], while the use of the micro-histological examination is reserved for indeterminate cases (C3 and C4 lesions) and for lesions that are not visible in ultrasound....

Anita Spezzacatene, MD; Maura Tonutti, MD; Fabiola Giudici, BAM; Marina Bortul, MD; Fabrizio Zanconati, MD; Maria Assunta Cova, MD. University of Trieste, Italy.

1. Rageth CJ, O’Flynn EA, Comstock C, Kurtz C, Kubik R, Madjar H, Lepori D, Kampmann G, Mundinger A, Baege A, Decker T, Hosch S, Tausch C, Delaloye JF, Morris E, Varga Z. First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res Treat. 2016;159:1–11. 2. Strachan C, Horgan K, Millican-Slater RA, Shaaban AM, Sharma N, to Strachan CC. Outcome of a new patient pathway for managing B3 breast lesions by vacuum-assisted biopsy: time to change current...