Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

被引：47

作者：

Elfgen, Constanze ^{[1
,2
]}

Leo, Cornelia ^{[3
]}

Kubik-Huch, Rahel A. ^{[4
]}

Muenst, Simone ^{[5
]}

Schmidt, Noemi ^{[6
]}

Quinn, Cecily ^{[7
,8
,9
]}

McNally, Sorcha ^{[10
]}

van Diest, Paul J. ^{[11
]}

Mann, Ritse M. ^{[12
,13
]}

Bago-Horvath, Zsuzsanna ^{[14
]}

Bernathova, Maria ^{[15
]}

Regitnig, Peter ^{[16
]}

Fuchsjaeger, Michael ^{[17
]}

Schwegler-Guggemos, Daniela ^{[18
]}

Maranta, Martina ^{[19
]}

Zehbe, Sabine ^{[20
]}

Tausch, Christoph ^{[1
]}

Guth, Uwe ^{[1
]}

Fallenberg, Eva Maria ^{[21
,22
]}

Schrading, Simone ^{[23
]}

Kothari, Ashutosh ^{[24
]}

Sonnenschein, Martin ^{[25
]}

Kampmann, Gert ^{[26
]}

Kulka, Janina ^{[27
]}

Tille, Jean-Christophe ^{[28
]}

Korner, Meike ^{[29
]}

Decker, Thomas ^{[30
]}

Lax, Sigurd F. ^{[31
,32
]}

Daniaux, Martin ^{[33
]}

Bjelic-Radisic, Vesna ^{[2
,34
]}

Kacerovsky-Strobl, Stephanie ^{[35
]}

Condorelli, Rosaria ^{[36
]}

Gnant, Michael ^{[37
]}

Varga, Zsuzsanna ^{[38
]}

机构：

[1] Breast Ctr Zurich, Zurich, Switzerland

[2] Univ Witten Herdecke, Witten, Germany

[3] Kantonsspital Baden, Breast Ctr, Baden, Switzerland

[4] Kantonsspital Baden, Dept Radiol, Baden, Switzerland

[5] Univ Hosp Basel, Inst Med Genet & Pathol, Basel, Switzerland

[6] Univ Hosp Basel, Dept Radiol, Basel, Switzerland

[7] Univ Coll Dublin, Irish Natl Breast Screening Program, Dublin, Ireland

[8] Univ Coll Dublin, St Vincents Univ Hosp Dublin, Dept Histopathol, Dublin, Ireland

[9] Univ Coll Dublin, Sch Med, Dublin, Ireland

[10] St Vincent Univ Hosp, Radiol Dept, Dublin, Ireland

[11] Univ Med Ctr Utrecht, Dept Pathol, Utrecht, Netherlands

[12] Radboud Univ Nijmegen Med Ctr, Dept Radiol, Nijmegen, Netherlands

[13] Netherlands Canc Inst, Dept Radiol, Amsterdam, Netherlands

[14] Med Univ Vienna, Dept Pathol, Vienna, Austria

[15] Med Univ Vienna, Dept Radiol & Nucl Med, Vienna, Austria

[16] Med Univ Graz, Diagnost & Res Inst Pathol, Graz, Austria

[17] Med Univ Graz, Dept Radiol, Div Gen Radiol, Graz, Austria

[18] Cty Hosp Aarau, Dept Radiol, Aarau, Switzerland

[19] Cty Hosp Chur, Dept Gynecol, Chur, Switzerland

[20] Breast Ctr Stephanshorn, Radiol Sect, St Gallen, Switzerland

[21] Tech Univ Munich TUM, Sch Med, Dept Diagnost & Intervent Radiol, Munich, Germany

[22] Tech Univ Munich TUM, Klinikum Rechts Isar, Munich, Germany

[23] Cty Hosp Lucerne, Dept Radiol, Luzern, Switzerland

[24] Guys & St Thomass NHS Fdn Trust, Breast Surg Unit, London, England

[25] Breast Ctr Lindenhofgruppe AG, Radiol Sect, Bern, Switzerland

[26] Ctr Radiol & Senol Luganese, Lugano, Switzerland

[27] Semmelweis Univ Budapest, Dept Pathol Forens & Insurance Med, Budapest, Hungary

[28] Univ Hosp Geneva, Div Clin Pathol, Geneva, Switzerland

[29] Pathol Langgasse, Ittigen, Switzerland

[30] Univ Hosp Munster, Reference Ctr Mammog Munster, Breast Pathol, Munster, Germany

[31] Johannes Kepler Univ Linz, Hosp Graz 2, Dept Pathol, Linz, Austria

[32] Johannes Kepler Univ Linz, Sch Med, Linz, Austria

[33] Univ Hosp Innsbruck, BrustGesundheitZentrum Tirol, Innsbruck, Austria

[34] Univ Witten Herdecke, Helios Univ Hosp, Breast Unit, Witten, Germany

[35] Franziskus Hosp, Breast Ctr, Vienna, Austria

[36] Ente Osped Cantonale, IOSI, Bellinzona, Switzerland

[37] Med Univ Vienna, Comprehens Canc Ctr, Vienna, Austria

[38] Univ Hosp Zurich, Dept Pathol & Mol Pathol, Zurich, Switzerland

来源：

VIRCHOWS ARCHIV | 2023年 / 483卷 / 01期

关键词：

Vacuum-assisted biopsy; B3; lesion; Uncertain malignant potential; ADH; LN; FEA; Radial Scar; Phyllodes tumor; Papilloma; Core-needle biopsy; Consensus; Vacuum-assisted excision; Breast surgery; ATYPICAL DUCTAL HYPERPLASIA; CORE NEEDLE-BIOPSY; TERM-FOLLOW-UP; RADIAL SCARS; LOBULAR NEOPLASIA; QUALITY-ASSURANCE; PHYLLODES TUMORS; UPGRADE RATE; DIAGNOSIS; RISK;

D O I：

10.1007/s00428-023-03566-x

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

The heterogeneous group of B3 lesions in the breast harbors lesions with different malignant potential and progression risk. As several studies about B3 lesions have been published since the last Consensus in 2018, the 3rd International Consensus Conference discussed the six most relevant B3 lesions (atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), radial scar (RS), papillary lesions (PL) without atypia, and phyllodes tumors (PT)) and made recommendations for diagnostic and therapeutic approaches. Following a presentation of current data of each B3 lesion, the international and interdisciplinary panel of 33 specialists and key opinion leaders voted on the recommendations for further management after core-needle biopsy (CNB) and vacuum-assisted biopsy (VAB). In case of B3 lesion diagnosis on CNB, OE was recommended in ADH and PT, whereas in the other B3 lesions, vacuum-assisted excision was considered an equivalent alternative to OE. In ADH, most panelists (76%) recommended an open excision (OE) after diagnosis on VAB, whereas observation after a complete VAB-removal on imaging was accepted by 34%. In LN, the majority of the panel (90%) preferred observation following complete VAB-removal. Results were similar in RS (82%), PL (100%), and FEA (100%). In benign PT, a slim majority (55%) also recommended an observation after a complete VAB-removal. VAB with subsequent active surveillance can replace an open surgical intervention for most B3 lesions (RS, FEA, PL, PT, and LN). Compared to previous recommendations, there is an increasing trend to a de-escalating strategy in classical LN. Due to the higher risk of upgrade into malignancy, OE remains the preferred approach after the diagnosis of ADH.

引用

页码：5 / 20

页数：16

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