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  • Poster presentation
  • Open Access

PB.31: B3 lesions and vacuum-assisted biopsy: a national survey to gauge current practice

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Breast Cancer Research201315 (Suppl 1) :P31

  • Published:


  • National Survey
  • Papilloma
  • National Guideline
  • Malignant Potential
  • Excision Biopsy


Breast screening detects asymptomatic abnormalities which occasionally on biopsy are classified indeterminate (B3). Such lesions have malignant potential and traditionally are subject to open diagnostic excision biopsy. Vacuum-assisted biopsy (VAB) offers larger representative tissue sampling, and may act as a therapeutic measure completely excising the lesion. The use of VAB in the NHSBSP varies widely. Currently there are no relevant national guidelines to streamline practice.


A survey was sent to 80 screening units throughout England, comprising seven questions concerning the use of VAB for B3 lesions.


Fifty-four responses (67.5%) were received. Twenty-two per cent of units do not perform VAB, 55% perform first-line and 77.8% second-line VAB. For B3 lesions without atypia, 68% would proceed to second-line VAB whilst 25% advocate open diagnostic excision following initial (14G) core. Management of B3 lesions with atypia was more discordant, with the majority of units opting for second-line VAB for FEA, ALH and LCIS, and second-line diagnostic excision for radial scars, ADH (atypical intraductal proliferation) and papillomas with atypia. Following first-line VAB, most units would proceed to diagnostic excision rather than second-line VAB.


Management of B3 lesions varies significantly across screening units. There is no concordance in the use of VAB for diagnosis or management of B3 lesions. Whilst there is a trend toward second-line VAB for atypias, significant numbers still opt for diagnostic excision. Consensual national guidelines to standardise and guide management would provide equity of care for this difficult management entity.

Authors’ Affiliations

St James University Hospital, Leeds, UK


© Strachan et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.