To review the pathologic classification of lesions on core biopsy, with emphasis on lesions of uncertain malignant potential (B3). To illustrate correlation of imaging findings (mammogram, US, MR) of B3 lesions from our series of breast lesions with pathologic correlation. To emphasize pitfalls, diagnostic difficulties, differential diagnosis and management.

Core biopsy is widely employed, in order to analyze breast lesions and avoid surgery in benign lesions. Biopsy helps in obtaining the definitive diagnosis of benign lesions, and also provides information on tumor subtype, histological grade, invasive status, and receptor status in malignant lesions. Different types of biopsyare availabledepending on guidance method, which is selected according to lesion type. Microcalcifications are usually biopsied with stereotactic guidance, nodules with US guidance and lesions detected only on MR need MR biopsy guidance( Fig. 1 ). Moreover, different...

Table of contents ( Table 1 ) 1.Pathologicclassification of breast lesions on core biopsyaccording to the B code. The pathologic classification of core and vacuum biopsies can be made according to the B code, the reporting system produced by the UK National Coordinating Committee for Breast Screening Pathology (NCCBSP) and endorsed by the European Commission working group on breast screening pathology. The reporting categories aim togive an assessment approach, instead ofa definitive diagnosis. They are based only on the histology of the specimen not considering...

B3 lesions are a heterogeneous group with a borderline histological spectrum at core needle biopsy and a variable risk of associated malignancy, with variable rates of upgrade on surgery. Radiologists should be aware of B3 lesions. Knowledge of the different entities, presentation and imaging is important as radio-pathologic correlation is essential in patient evaluation ( Fig. 15 ). Remember entities frequently upgraded at excision, an indication for surgery: atypical ductal hyperplasia (ADH), and atypical papillary lesions, .

R. M. Lorente Ramos1, ([email protected]) F. J. Azpeitia Armán1, C. Oliva Fonte1, J. M. López Arcas Calleja1, J. M. García Gómez1, M. T. Rivera García2 1.- Unidad Central de Radiodiagnóstico de la CAM. Hospital Universitario Infanta Leonor (Vallecas) 2.- Pathology Department. Hospital Universitarios Santa Cristina

1.I O Ellis, S Humphreys, M Michell, S E Pinder, C A Wells, H D Zakhour: UK National Coordinating Commmittee for Breast Screening Pathology; European Commission Working Group on Breast Screening Pathology..Best Practice No 179. Guidelines for breast needle core biopsy handling and reporting in breast screening assessment. J Clin Pathol. 2004;57(9):897-902. 2. Rageth CJ, O'Flynn EAM, Pinker K, Kubik-Huch RA, Mundinger A, Decker T, Tausch C, Dammann F, Baltzer PA, Fallenberg EM, Foschini MP, Dellas S, Knauer M, Malhaire C, Sonnenschein M, Boos A,...