Volume 17 Supplement 1
Safety of vacuum-assisted biopsy/mammatome guided, non-operative management of B3 lesions with atypia: a 7-year follow-up study
© Wilkins et al. 2015
Published: 5 November 2015
B3 management balances safe treatment of potential malignancy against the morbidity of surgical excision of benign lesions. Vacuum-assisted biopsy (VAB) increases diagnostic accuracy, removing some lesions entirely without surgery. Few follow-up data are available to assess the safety and effectiveness of this approach.
A total of 129 patients with B3 VAB with atypia were identified using Labcentre histopathology codes at a single centre. Hospital and NBSS records were analysed to identify patients treated with VAB and mammographic surveillance alone and to determine outcome over a follow-up period of 52−142 months (median 85).
Ten per cent progressed directly to surgery (13/129). A total of 116 were followed mammographically after VAB with no surgical intervention (49 ADH, 2 ALH, 21 LCIS, 44 atypia (not otherwise specified)). Nine patients re-presented to the service with invasive carcinoma (six ipsilateral) and two with DCIS (both ipsilateral) between 12 and 80 months. The ipsilateral re-presentation rate was highest for ADH (5/49) and LCIS (2/21). In the absence of ADH or LCIS, the only ipsilateral representation was one low-grade DCIS, 62 months after VAB.
Re-presentation with ipsilateral carcinoma following VAB excision for ADH and LCIS is comparable to surgical excision for ADH and LCIS. National guidance is required.
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 (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.