Breast lesions are histologically classified as B1 (B1-lesions) when the specimen is composed of normal breast tissue, with or without parenchymal breast structures, or when the sample is inadequate for diagnostic evaluation [1, 2]. In both cases, the management of these lesions is challenging for the radiologist: biopsied lesions have variable but always-significant degree of suspicion, based on different clinical and imaging features, that are well-coded [3]. The underestimation rates of biopsies performed under ultrasound [4, 5, 6], stereotactic [7], and MR guidance [8] are...

Patient population: we retrospectively identified all patients who underwent breast biopsies classified as B1 in the period between June 2012 and June 2015 in our Institute, searching for “B1” and “inadequate” in the RIS of our Hospital. Patients who received a diagnosis of B1-lesion without a follow-up of at least 2 years and without a second histologic assessment (percutaneous or surgical) were excluded [1, 2]. All the other patients who received a diagnosis of B1-lesion were included. Data acquisition: all patients underwent digital mammography and...

Patient population: during the period between June 2012 and June 2015, among 3518 percutaneous breast biopsies performed under ultrasound, stereotactic or MRI guidance in our Institute, 85 were classified as B1 (0.02%). The mean age of these women was 55.2 years (range 27-80 years). Imaging guidance: among 85 B1-lesions, 4 biopsies (4.7%) were performed under stereotactic guidance, while 81 biopsies (95.3%) were performed under ultrasound guidance. None of the biopsies performed under MR guidance was classified as B1. Histopathological findings: among 85 B1-lesions, 70 (82.4%)...

In our experience, the rate of B1-lesions is very low, comparable with the one reported in previously published papers [11]. However, even if the rate is very low, a diagnosis of B1-lesion is worrisome for the patient and challenging for the breast radiologist. What to do next? Such a question is highly relevant, since in our population the rate of breast cancers diagnosed after a diagnosis of B1-lesion was significant (21.2%). Notably, our rate of malignant lesions was higher than the one reported by Rakha...

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Perry N, Broeders M, de Wolf C, Tornberg S, Holland R, von Karsa L. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition--summary document. Ann Oncol. 2007;19: 614–622. doi:10.1093/annonc/mdm481 Ellis IO. Best Practice No 179: Guidelines for breast needle core biopsy handling and reporting in breast screening assessment. J Clin Pathol. 2004;57: 897–902. doi:10.1136/jcp.2003.010983 D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA, et al. ACR BI-RADS®Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013 J. H....