Management of B3 lesions of the breast: implementations of current recommendations in clinical practice

Stereotactic needle breast biopsy and vacuum assisted breast biopsy have replaced wide local excision in the last decades. B3 lesions of the breast represent a particular subgroup which is difficult to manage. The purpose of the present study was to present our experience with this specific type of lesions and to examine the conformity of Princess Margaret Hospital with current recommendations.

We retrospectively searched for patients that attended the Breast Clinic of Princess Alexandra Hospital during the period 2012-2015, and were diagnosed with B3 lesions during stereotactic needle core biopsy.

In total 24 patients with B3 lesions were identified. Among them 6 women had synchronous malignant lesions and were excluded from our study. From the remaining, 8 patients presented with a single B3 lesion and 10 with multiple B3 lesions. Twelve of our patients underwent stereotactic vacuum-assisted biopsy (VAB). Ten patients underwent only core biopsy, 8 underwent only VAB biopsy and 3 lesions were investigated with both core biopsy and VAB.

The findings of our study support the applicability of the current recommendations for the surgical management of B3 breast lesions. Core needle biopsies and VAB are equally efficacious with wide local excision for the differential diagnosis of lesions of uncertain malignant potential, thus limiting the necessity of open surgery.