Vacuum assisted biopsy versus surgical excision for diagnosis and monitoring of B3 papillary lesions
Association of Breast Surgery ePoster Library. Ain Q. 05/15/17; 166327; P045
Ms. Quratul Ain
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Abstract
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Introduction
B3 lesions are defined as those with uncertain malignant potential. Papillary lesions are one of these heterogenous group of breast lesions. One of challenges of the breast MDT can be identifying which of these need to proceed to surgical excision to ascertain a histological diagnosis. Current practice in this unit tends to air towards excision of these lesions. Recently vacuum assisted biopsy (VAB) has been used to try to gain more tissue sample in order to avoid large numbers of unnecessary surgical excision biopsies.
Methods
Patients who had B3 papillary lesions on core biopsy were identified from histopathology records. Trust medical records were searched to ascertain investigations performed and the results of these. Data was collected in a secure database and analysed statistically.
Results
125 patients were identified between January 2011 and November 2016 with B3 papillary lesions diagnosed by needle core biopsy. 15 of 125 patients did not have any subsequent procedures and were excluded from the analysis. Of the remaining 111 patients 92 proceeded to surgical excision biopsy without prior vacuum assisted biopsy (VAB). 12 of the 92 patients were diagnosed to have malignancy (in situ or invasive) making the upgrade rate for surgery 13.04%. 11 of 12 (91/67%) upgraded to DCIS and 1 (83.33%) had invasive carcinoma. 18 of 111 patients had VAB. 12 of these 18 patients went on to have subsequent excision biopsies and the other 6 were followed up on the basis of VAB alone. 3 of 18 who had VAB were upgraded to malignancy making the upgrade rate as 16.67% (3/18 DCIS). The patients who had VAB followed by surgery there were no malignancies giving the upgrade rate of 0%.
Conclusion and recommendations
The results of this stud show very identical upgrade rate for VAB group (16.67%) and surgical excision group (13.04%). Surgical excision following VAB had no additional yield of malignancy. The study demonstrates that VAB without surgical excision may be sufficient for managing B3 papillary lesions diagnosed with needle core biopsies. However, the numbers in the VAB group were small to reach a definite conclusion based on these figures alone. A more extensive inter-hospital study is to be planned for the future to addres
B3 lesions are defined as those with uncertain malignant potential. Papillary lesions are one of these heterogenous group of breast lesions. One of challenges of the breast MDT can be identifying which of these need to proceed to surgical excision to ascertain a histological diagnosis. Current practice in this unit tends to air towards excision of these lesions. Recently vacuum assisted biopsy (VAB) has been used to try to gain more tissue sample in order to avoid large numbers of unnecessary surgical excision biopsies.
Methods
Patients who had B3 papillary lesions on core biopsy were identified from histopathology records. Trust medical records were searched to ascertain investigations performed and the results of these. Data was collected in a secure database and analysed statistically.
Results
125 patients were identified between January 2011 and November 2016 with B3 papillary lesions diagnosed by needle core biopsy. 15 of 125 patients did not have any subsequent procedures and were excluded from the analysis. Of the remaining 111 patients 92 proceeded to surgical excision biopsy without prior vacuum assisted biopsy (VAB). 12 of the 92 patients were diagnosed to have malignancy (in situ or invasive) making the upgrade rate for surgery 13.04%. 11 of 12 (91/67%) upgraded to DCIS and 1 (83.33%) had invasive carcinoma. 18 of 111 patients had VAB. 12 of these 18 patients went on to have subsequent excision biopsies and the other 6 were followed up on the basis of VAB alone. 3 of 18 who had VAB were upgraded to malignancy making the upgrade rate as 16.67% (3/18 DCIS). The patients who had VAB followed by surgery there were no malignancies giving the upgrade rate of 0%.
Conclusion and recommendations
The results of this stud show very identical upgrade rate for VAB group (16.67%) and surgical excision group (13.04%). Surgical excision following VAB had no additional yield of malignancy. The study demonstrates that VAB without surgical excision may be sufficient for managing B3 papillary lesions diagnosed with needle core biopsies. However, the numbers in the VAB group were small to reach a definite conclusion based on these figures alone. A more extensive inter-hospital study is to be planned for the future to addres
Introduction
B3 lesions are defined as those with uncertain malignant potential. Papillary lesions are one of these heterogenous group of breast lesions. One of challenges of the breast MDT can be identifying which of these need to proceed to surgical excision to ascertain a histological diagnosis. Current practice in this unit tends to air towards excision of these lesions. Recently vacuum assisted biopsy (VAB) has been used to try to gain more tissue sample in order to avoid large numbers of unnecessary surgical excision biopsies.
Methods
Patients who had B3 papillary lesions on core biopsy were identified from histopathology records. Trust medical records were searched to ascertain investigations performed and the results of these. Data was collected in a secure database and analysed statistically.
Results
125 patients were identified between January 2011 and November 2016 with B3 papillary lesions diagnosed by needle core biopsy. 15 of 125 patients did not have any subsequent procedures and were excluded from the analysis. Of the remaining 111 patients 92 proceeded to surgical excision biopsy without prior vacuum assisted biopsy (VAB). 12 of the 92 patients were diagnosed to have malignancy (in situ or invasive) making the upgrade rate for surgery 13.04%. 11 of 12 (91/67%) upgraded to DCIS and 1 (83.33%) had invasive carcinoma. 18 of 111 patients had VAB. 12 of these 18 patients went on to have subsequent excision biopsies and the other 6 were followed up on the basis of VAB alone. 3 of 18 who had VAB were upgraded to malignancy making the upgrade rate as 16.67% (3/18 DCIS). The patients who had VAB followed by surgery there were no malignancies giving the upgrade rate of 0%.
Conclusion and recommendations
The results of this stud show very identical upgrade rate for VAB group (16.67%) and surgical excision group (13.04%). Surgical excision following VAB had no additional yield of malignancy. The study demonstrates that VAB without surgical excision may be sufficient for managing B3 papillary lesions diagnosed with needle core biopsies. However, the numbers in the VAB group were small to reach a definite conclusion based on these figures alone. A more extensive inter-hospital study is to be planned for the future to addres
B3 lesions are defined as those with uncertain malignant potential. Papillary lesions are one of these heterogenous group of breast lesions. One of challenges of the breast MDT can be identifying which of these need to proceed to surgical excision to ascertain a histological diagnosis. Current practice in this unit tends to air towards excision of these lesions. Recently vacuum assisted biopsy (VAB) has been used to try to gain more tissue sample in order to avoid large numbers of unnecessary surgical excision biopsies.
Methods
Patients who had B3 papillary lesions on core biopsy were identified from histopathology records. Trust medical records were searched to ascertain investigations performed and the results of these. Data was collected in a secure database and analysed statistically.
Results
125 patients were identified between January 2011 and November 2016 with B3 papillary lesions diagnosed by needle core biopsy. 15 of 125 patients did not have any subsequent procedures and were excluded from the analysis. Of the remaining 111 patients 92 proceeded to surgical excision biopsy without prior vacuum assisted biopsy (VAB). 12 of the 92 patients were diagnosed to have malignancy (in situ or invasive) making the upgrade rate for surgery 13.04%. 11 of 12 (91/67%) upgraded to DCIS and 1 (83.33%) had invasive carcinoma. 18 of 111 patients had VAB. 12 of these 18 patients went on to have subsequent excision biopsies and the other 6 were followed up on the basis of VAB alone. 3 of 18 who had VAB were upgraded to malignancy making the upgrade rate as 16.67% (3/18 DCIS). The patients who had VAB followed by surgery there were no malignancies giving the upgrade rate of 0%.
Conclusion and recommendations
The results of this stud show very identical upgrade rate for VAB group (16.67%) and surgical excision group (13.04%). Surgical excision following VAB had no additional yield of malignancy. The study demonstrates that VAB without surgical excision may be sufficient for managing B3 papillary lesions diagnosed with needle core biopsies. However, the numbers in the VAB group were small to reach a definite conclusion based on these figures alone. A more extensive inter-hospital study is to be planned for the future to addres
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