Your browser doesn't support javascript.
loading
Long-Term Follow-Up of High-Risk Breast Lesions at Vacuum-Assisted Biopsy without Subsequent Surgical Resection.
Elfgen, Constanze; Varga, Zsuzsanna; Breitling, Katrin; Pauli, Eliane; Schwegler-Guggemos, Daniela; Kampmann, Gert; Kubik-Huch, Rahel A; Leo, Cornelia; Lepori, Domenico; Sonnenschein, Martin; Tausch, Christoph; Schrading, Simone.
Afiliação
  • Elfgen C; Breast-Center Zurich, Zurich, Switzerland.
  • Varga Z; Department of Medicine, University of Witten-Herdecke, Witten, Germany.
  • Breitling K; Department of Pathology and Molecular Pathology, University Hospital Zürich, Zurich, Switzerland.
  • Pauli E; Breast Center, Kantonsspital Schaffhausen, Schaffhausen, Switzerland.
  • Schwegler-Guggemos D; Breast Center, Kantonsspital Frauenfeld, Frauenfeld, Switzerland.
  • Kampmann G; Department of Radiology, Kantonsspital Aarau, Aarau, Switzerland.
  • Kubik-Huch RA; Centro di Radiologia e Senologia Luganese, Lugano, Switzerland.
  • Leo C; Department of Radiology, Kantonsspital Baden, Baden, Switzerland.
  • Lepori D; Breast Center, Kantonsspital Baden, Baden, Switzerland.
  • Sonnenschein M; Imagerie du flon, Lausanne, Switzerland.
  • Tausch C; Radiology Section, Breast Center Lindenhofgruppe AG, Bern, Switzerland.
  • Schrading S; Breast-Center Zurich, Zurich, Switzerland.
Breast Care (Basel) ; 19(1): 62-72, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38384485
ABSTRACT

Introduction:

B3-lesions of the breast are a heterogeneous group of neoplasms, associated with a higher risk of breast cancer. Recent studies show a low upgrade rate into malignancy after subsequent open surgical excision (OE) of most B3-lesions when proven by vacuum-assisted biopsy (VAB). However, there is a lack of long-term follow-up data after VAB of high-risk lesions. The primary aim of this study was to demonstrate whether follow-up of B3 lesions is a beneficial and reliable alternative to OE in terms of long-term outcome. The secondary aim was to identify patient and lesion characteristics of B3 lesions for which OE is still necessary.

Methods:

This retrospective multicenter study was conducted at 8 Swiss breast centers between 2010 and 2019. A total of 278 women (mean age 53.5 ± 10.7 years) with 286 B3-lesions who had observation only and who had at least 24 months of follow-up were included. Any event during follow-up (ductal carcinoma in situ [DCIS], invasive cancer, new B3-lesion) was systematically recorded. Data from women who had an event during follow-up were compared with those who did not. The results for the different B3 lesions were analyzed using the t test and Fisher's exact test. A p value of <0.05 was considered statistically significant.

Results:

The median follow-up interval was 59 months (range 24-143 months) with 52% (148/286) having a follow-up of more than 5 years. During follow-up, in 42 women, 44 suspicious lesions occurred, with 36.4% (16/44) being invasive cancer and 6.8% (3/44) being DCIS. Thus, 6.6% (19/286) of all women developed malignancy during follow-up after a median follow-up interval of 6.5 years (range 31-119 months). The initial histology of the B3 lesion influenced the subsequent occurrence of a malignant lesion during follow-up (p < 0.038). The highest malignancy-developing rate was observed in atypical ductal hyperplasia (ADH) (24%, 19/79), while all other B3-lesions had malignant findings ipsi- and contralateral between 0% and 6%. The results were not influenced by the VAB method (Mx-, US-, magnetic resonance imaging-guided), the radiological characteristics of the lesion, or the age or menopausal status of the patient (p > 0.12).

Conclusion:

With a low risk of <6% of developing malignancy, VAB followed by long-term follow-up is a safe alternative to OE for most B3-lesions. A higher malignancy rate only occurred in ADH (24%). Based on our results, radiological follow-up should be bilateral, preferable using the technique of initial diagnosis. As we observed a late peak (6-7 years) of breast malignancies after B3-lesions, follow-up should be continued for a longer period (>10 years). Knowledge of these long-term outcome results will be helpful in making treatment decisions and determining the optimal radiological follow-up interval.
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Breast Care (Basel) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Suíça País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Breast Care (Basel) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Suíça País de publicação: Suíça