Follow-Up, Biopsy, or Surgical Excision of Palpable Probably Benign Breast Lesions

Abstract Lactating adenomas are benign breast lesions that occur in pregnant, lactating, and postpartum women. These lesions have no associated malignant potential; their origin is disputed with no consensus on whether they represent hyperplastic or neoplastic processes. On ultrasound, lactating adenomas are classically described as solid, circumscribed, parallel masses with iso/hypoechoic internal echotexture and posterior enhancement. Histologically, lactating adenomas appear as circumscribed nodules of tightly packed lobular acini with extensive lactational change during pregnancy or the postpartum period. Masses in pregnant and lactating women with probably benign imaging characteristics—oval, circumscribed, parallel, iso/hypoechoic—can be managed with short interval follow-up (BI-RADS 3) rather than biopsy. However, lactating adenomas can also demonstrate characteristics that overlap with pregnancy-associated breast cancer, such as margins that are not circumscribed, prompting biopsy to exclude pregnancy-associated carcinoma. Breast imaging radiologists must be aware of the variable appearances of lactating adenomas to appropriately manage pregnant and lactating women presenting with palpable lumps.

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Benign Breast Lesions: Minimally Invasive Vacuum-assisted Biopsy with 11-Gauge Needles—Patient Acceptance and Effect on Follow-up Imaging Findings

Radiology ◽

10.1148/radiol.2271011933 ◽

2003 ◽

Vol 226 (3) ◽

pp. 783-790 ◽

Cited By ~ 31

Author(s):

Sabine Huber ◽

Monika Wagner ◽

Michael Medl ◽

Heinrich Czembirek

Keyword(s):

Minimally Invasive ◽

Patient Acceptance ◽

Breast Lesions ◽

Imaging Findings ◽

Benign Breast Lesions

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Patient reported cosmetic outcome after vacuum assisted excision of benign breast lesions: a cross-sectional study

British Journal of Radiology ◽

10.1259/bjr.20190994 ◽

2020 ◽

Vol 93 (1114) ◽

pp. 20190994

Author(s):

Elles M.F. van de Voort ◽

Taco M.A.L. Klem ◽

Gerson M. Struik ◽

Erwin Birnie ◽

Renata H.J.A. Sinke ◽

...

Keyword(s):

Tumor Size ◽

Surgical Excision ◽

Cosmetic Outcome ◽

Study Patient ◽

Breast Lesions ◽

Benign Lesions ◽

Complete Excision ◽

Cross Sectional ◽

Patient Reported ◽

Benign Breast Lesions

Objective: Better cosmetic outcome after vacuum assisted excision (VAE) compared to surgical excision of benign breast lesions is suggested in previous studies but has never been evaluated with validated outcome measures. In this study, patient reported cosmetic outcome after VAE was evaluated. Methods: Patients who underwent VAE between July 2017 and December 2018 were invited to complete the cosmetic subscale of the Dutch Breast Cancer Treatment Outcome Scale, comparing the treated with the untreated breast. Response mode ranged from 1 (no difference) to 4 (large difference) and cosmetic outcome was calculated as the unweighted mean. Clinical outcomes included: tumor size, number of cores, complications, residual lesions and recurrences. Results: Response rate was 73.4% (47 of 64 patients). Median tumor size was 15 mm (range 5–51 mm) and median number of cores 6.5 (range 1–85), complete excision was confirmed in all but two patients. Mean cosmetic outcome was good (mean score ≤1.75) in 74% of patients and no patients reported a poor cosmetic outcome (mean score >3.25). A hematoma occurred in five patients (one needed aspiration) and a skin rash in one patient, no patients developed an infection or seroma. Conclusion: In this study VAE is safe and effective for tumors up to 5 cm and patient reported cosmetic outcome was good. Patients with benign lesions could benefit from VAE as an alternative for surgical excision. Advances in knowledge: A formal quantitative measurement of cosmetic outcome after vacuum assisted excision for benign breast lesions was still lacking. This study shows that this cosmetic outcome is overall good in benign lesions up to 5 cm.

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Imaging-Histological Discordance after Sonographically Guided Percutaneous Breast Core Biopsy

Breast Care ◽

10.1159/000370219 ◽

2014 ◽

Vol 10 (1) ◽

pp. 33-37 ◽

Cited By ~ 9

Author(s):

Aykut Soyder ◽

Füsun Taşkın ◽

Serdar Ozbas

Keyword(s):

Core Biopsy ◽

Breast Biopsy ◽

Surgical Excision ◽

Excisional Biopsy ◽

Breast Lesions ◽

Core Needle ◽

Ductal Carcinomas ◽

Histological Results

Background: The objectives of this study were to determine the frequency of imaging-histological discordance and to compare the frequency of carcinoma between discordant lesions at ultrasound (US)-guided core needle biopsy. Materials and Methods: From November 2009 to June 2012, we performed US-guided 14-gauge core needle biopsies on 989 breast lesions in 961 women. We reviewed 58 (5.8%) cases that had imaging-histological discordance after percutaneous breast biopsy and underwent subsequent excisional biopsy. The clinical, radiological, and histological findings were reviewed for those 58 cases. Results: Among the 58 cases, subsequent excisions revealed 16 (27.5%) malignancies, which were categorized as 9 (15.5%) invasive ductal carcinomas, 4 (6.9%) malignant phyllodes tumors, and 3 (5.1%) ductal carcinomas in situ. Conclusion: The malignancy rate of 27.5% suggests that surgical excision should be performed in those cases presenting with imaging-histological discordance after US-guided core biopsy. Careful correlation of clinical, radiological, and histological results as well as appropriate follow-up are essential.

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