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Role of breast imaging in predicting outcome of lesions of uncertain malignant potential (B3) diagnosed at core needle biopsy

Abstract

Aims

To elucidate whether breast imaging can predict final histologic diagnosis of lesions of uncertain malignant potential diagnosed at ultrasound core needle biopsy (CNB).

Methods

The imaging characteristics (mammography, ultrasound, and magnetic resonance imaging [MRI]) of lesions of uncertain malignant potential in the breast that were obtained by ultrasound CNB were retrospectively analyzed in 87 women. Radiologic characteristics of lesions were compared to definitive histopathologic findings.

Results

Out of 87 breast lesions of uncertain malignant potential, 27 (31%) were diagnosed as papillary lesions, 24 (28%) atypical ductal hyperplasia, 19 (22%) lobular intraepithelial neoplasia, 9 (10%) phyllodes tumors, 3 (3%) radial sclerosing lesions, and 5 (6%) unspecified lesions of uncertain malignant potential. The underestimation rate of malignancy at CNB based on the total number of lesions on final follow-up was 22%. Using multivariate logistic regression, Breast Imaging-Reporting and Data System (BI-RADS) score (odds ratio [OR] = 12.29, p = 0.027) and Göttingen MRI scoring system (OR = 8.1, p = 0.008) were found to be independent predictors of malignancy. Receiver operating characteristic analysis showed that Göttingen MRI score >3 provides a plausibly good cutoff value with sensitivity of 100 (95% confidence interval [CI] 74%-100%) and specificity of 76% (95% CI 61%-88%).

Conclusions

Lesions of uncertain malignant potential classified as BI-RADS 5 and Göttingen score 4 or higher are at significantly higher risk of harboring malignancy and therefore should be recommended for surgical excision.

Tumori 2016; 102(2): 203 - 208

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000398

Authors

Marko Petrovecki, Ana Marija Alduk, Jasminka Jakic-Razumovic, Ranka Stern-Padovan, Vinko Bubic, Maja Prutki

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Department of Radiology, Clinical Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb - Croatia
  • Department of Pathology and Cytology, Clinical Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb - Croatia
  • Community Health Center East, Zagreb - Croatia

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