A Ten-year, Single-center Experience: Concordance Between Breast Core Needle Biopsy/vacuum-assisted Biopsy and Postoperative Histopathology in B3 and B5a Cases

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2020 May 22

PMID 32437426

Citations 2

Authors

Mohamed Elsharkawy

Thomas Vestring

Hans-Juergen Raatschen

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine the concordance rate between core needle biopsy/vacuum-assisted biopsy (CNB/VAB) and postoperative histopathology in B3 (lesions of uncertain malignant potential) and B5a (in situ) lesions found on mammograms or ultrasound.

Material And Methods: 2,029 consecutive biopsies performed over 10 years for patients who underwent mammograms or ultrasounds. For CNB 14G needle and for VAB 8G/10G needles were used. In all biopsies, we identified the age, BI-RADS®, histopathological biopsy results, B-category, nuclear grade for DCIS and postoperative histopathology results in B3 and B5a cases from the biopsy.

Results: The B-categories from CNB/VAB were as follows: B2 42.2 percent (n = 856), B3 4.5 percent (n = 91), B5a 5.7 percent (n = 115), and B5b 47.6 percent (n = 967). In the B3-category, 72/91 patients underwent surgical excision, with a concordance rate of 83.3 percent (n = 60/72) and a discordance rate of 16.7 percent (n = 12/72) to postoperative histopathology. From the discordant cases, 67.7 percent (n = 8/12) showed DCIS and 32.3 percent (n = 4/12) showed invasive breast cancer. The BIRADS of the discordant cases was 4b in 41.7 percent (n = 5/12) and 5 in 58.3 percent (n = 7/12). The PPVs for malignancy of B3 lesions were 0.21, with no statistical significance between subgroups. In the B5a-category, 101 of 115 patients underwent surgery in our hospital, with a concordance rate of 80.2 percent (n = 81/101) and a discordance rate of 19.8 percent (n = 20/101) to postoperative histopathology. From the discordant cases, 55 percent (n = 11/20) showed invasive breast carcinoma of no special type (NST).

Conclusion: Our concordance rate for B3 (83.3 percent) and B5a (80.2 percent) lesions in the biopsies to postoperative histopathology is matching to previously published literature. Surgical excision is our recommendation for lesions biopsied with a B3 category in the histopathology and a BIRADS category of (4b, 4c and 5). The PPVs for malignancy of B3 lesions showed no statistical significance between subgroups. Also, the nuclear grade of DCIS was not statistically significant in terms of upgrade into invasive breast cancer.

Citing Articles

Assessing Malignant Risk in B3 Breast Lesions: Clinical Insights and Implications.

DArchi S, Carnassale B, Accetta C, Belli P, De Lauretis F, Di Guglielmo E J Clin Med. 2025; 14(1.

PMID: 39797153 PMC: 11721960. DOI: 10.3390/jcm14010070.

Breast lesions excised via vacuum-assisted system: could we get any clues for B3 lesions before excision biopsy?.

Zheng L, Zheng F, Xing Z, Zhang Y, Li Y, Xu H BMC Cancer. 2021; 21(1):633.

PMID: 34049527 PMC: 8164321. DOI: 10.1186/s12885-021-08382-7.

The role of MRI and clinicopathologic features in predicting the invasive component of biopsy-confirmed ductal carcinoma in situ.

Yoon G, Choi W, Cha J, Shin H, Chae E, Kim H BMC Med Imaging. 2020; 20(1):95.

PMID: 32787871 PMC: 7424652. DOI: 10.1186/s12880-020-00494-z.

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