High risk (B3) breast lesions: What is the incidence of malignancy for individual lesion subtypes? A systematic review and meta-analysis

Publication date: Available online 11 December 2018Source: European Journal of Surgical OncologyAuthor(s): Nerys Dawn Forester, Simon Lowes, Elizabeth Mitchell, Maureen TwiddyAbstractIntroductionProvide evidence to support evolving management strategies for high-risk (B3) breast lesions by assessing risk of carcinoma in subgroups of B3 lesions using systematic review and meta-analysis.MethodsDatabases identified observational studies between 1980 and 2015 that reported on underestimation of malignancy following B3 lesion diagnosis at core needle biopsy. Critical appraisal, quality assessment, data extraction and meta-analysis was undertaken to calculate rate of malignancy of the whole B3 group and individual lesions. Study heterogeneity and association between variables and underestimation rate was investigated using random effects logistic modelling.ResultsMeta-analysis, using data from 129 studies, assessed 11 423 lesions of which 2160 were upgraded to malignancy after surgical excision biopsy (17% malignancy rate, 95% CI 15–19%). Malignancy rates varied from 6% in radial scars with no atypia (95% CI 2–13%, I2 72.8%), to 32% in papillomas with atypia (95% CI 23–41%, I2 57.4%). Differences in upgrade rates between atypical and non-atypical lesions were statistically significant (p 
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research

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This study sought to identify clinicopathological factors associated with upstaging and axillary metastasis in patients preoperatively diagnosed with DCIS by CNB.Materials and MethodsThis study identified 604 patients (cT1 ‐3N0M0) with preoperative diagnosis of pure DCIS by CNB who had undergone axillary evaluation from August 2006 to December 2015 at Fudan University Shanghai Cancer Center (FUSCC). Predictors of upstaging and axillary lymph nodes metastasis were analyzed, respectively.ResultsOf all 604 patients, 121 (20.03%) and 193 (31.95%) patients were upstaged to DCIS with microinvasion (DCISM) and invasive breast c...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
AbstractPurposeThe future of non-operative management of DCIS relies on distinguishing lesions requiring treatment from those needing only active surveillance. More accurate preoperative staging and grading of DCIS would be helpful. We identified determinants of upstaging preoperative breast biopsies showing ductal carcinoma in situ (DCIS) to invasive breast cancer (IBC), or of upgrading them to higher-grade DCIS, following examination of the surgically excised specimen.MethodsWe studied all women with DCIS at preoperative biopsy in a large specialist cancer centre during 2000 –2014. Information from clinical records...
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
ConclusionsA pre-operative core biopsy diagnosis of “malignant spindle cell neoplasm” separates MP and SC from BLP, BP, and FA. However, MP and SC can have overlapping features on core biopsy. Thus, one must be careful not to overcall SC on core biopsy, as patients diagnosed with SC may receive neoadjuvant therapy. A core biopsy diagnosis of “p hyllodes tumor” is specific for PT and can guide treatment planning of a wide local excision.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
AbstractBackgroundThe density of tumor-infiltrating lymphocytes (TIL) is a predictive factor for response to neoadjuvant systemic therapy (NAST) in breast cancer. High TIL density correlates with higher complete pathologic remission (pCR) in triple negative and HER2 positive breast cancer. Additionally, not only TIL density but also subsets of immune cells in tumor stroma seem to play an important role in cancer and immune cell interaction and response to chemotherapy. Our aim is to determine TIL density and expression of CD 20, CD3, CD8, PD-L1, FOXP3 and PGM1 on core biopsy specimen and find a correlation with pCR.Trial d...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
We report on a breast carcinoma with medullary features diagnosed by core needle biopsy in a 72-year-old woman. Both the primary tumour and its fine needle aspiration-proven, rapidly growing axillary metastasis regressed completely in less than 2 months, by the time surgery was performed. The biopsy of the primary tumour demonstrated a dense stromal infiltrate of CD8+/granzyme B+ activated cytotoxic T-cells suggestive of a robust antitumour immune response. Paradoxically, both tumour cells and tumour infiltrating immune cells demonstrated a diffuse PD-L1 expression, revealing that antitumour immune...
Source: Polish Journal of Pathology - Category: Pathology Tags: Pol J Pathol Source Type: research
We report the case of a 67-year-old woman with a metastatic breast tumor derived from a BRAF V600E mutant rectal carcinoma that was diagnosed and resected curatively 1 year previously. Computed tomography showed a left breast mass and multiple lung nodules suspected to be indicative of recurrent rectal cancer. The ultrasonography examination demonstrated a 10 × 10-mm hypoechoic solid lesion in the left breast with an elevation in the serum carcinoembryonic antigen level and serum carbohydrate antigen 19-9 level. Core needle biopsy was performed, and histopathologic examination showed Cytokeratin 20...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Tags: Clin J Gastroenterol Source Type: research
CONCLUSION: B3 lesions entail a heterogeneous risk of malignancy, and careful radiologic-pathologic correlation is required for optimal treatment. PMID: 31451072 [PubMed - as supplied by publisher]
Source: Tumori - Category: Cancer & Oncology Tags: Tumori Source Type: research
SONOELASTOGRAPHIC FEATURES OF HIGH-RISK BREAST LESIONS AND DUCTAL CARCINOMA IN SITU - A PILOT STUDY. Acta Clin Croat. 2019 Mar;58(1):13-22 Authors: Crnogorac M, Ivanac G, Tomasović-Lončarić Č, Žic R, Kelava T, Brkljačić B Abstract The aim of this study was to evaluate the quantitative sonoelastographic values recorded on shear-wave sonoelastography (SWE) of high-risk breast lesions and ductal carcinoma in situ (DCIS). We retrospectively analyzed histopathologic and SWE data (quantitative maximum, minimum and mean stiffness, lesion-to-fat ratio (E-ratio), lesion size) of 228 women referred to our...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
Abstract To clarify the surgical outcomes of breast cancer patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy (CNB) (abbreviated as CNBDCIS), we retrospectively analyzed the cases of 131 patients with CNBDCIS who underwent surgery at Oomoto Hospital (32 total mastectomies, 99 conservative mastectomies). Our analysis of underestimation and predictors of invasive breast cancer of CNBDCIS revealed that the underestimation rate of CNBDCIS was 40.5% (53/131). A logistic regression analysis revealed that palpable tumors (yes to no, odds ratio [OR] 3.25), mammography (MMG) cat...
Source: Acta Med Okayama - Category: Universities & Medical Training Authors: Tags: Acta Med Okayama Source Type: research
Publication date: Available online 30 July 2019Source: NeurocomputingAuthor(s): Zhanbo Yang, Lingyan Ran, Shizhou Zhang, Yong Xia, Yanning ZhangAbstractHistology images analysis resulted from needle biopsy serves as the gold standard for breast cancer diagnosis. Deep learning-based classification of breast tissues in histology images, however, is less accurate, due to the lack of adequate training data and ignoring the multiscale structural and textural information. In this paper, we propose the Ensemble of MultiScale convolutional neural Networks (EMS-Net) to classify hematoxylin-eosin stained breast histopathological mic...
Source: Neurocomputing - Category: Neuroscience Source Type: research
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