Our Summary

This research paper looks at a specific type of abnormal breast cells classified as “uncertain malignant potential” or B3. These cells could potentially lead to cancer, and the study focused on how to best treat them. The researchers examined the patient outcomes for two different treatment approaches: surgical removal of the cells or a less invasive procedure known as vacuum-assisted breast biopsy (VABB).

The study looked at 1250 VABB procedures performed over 11 years and found 150 cases of B3 cells. 68 of these cases underwent surgical removal and the rest were monitored. The researchers then compared the results of the two groups.

They found that the rate of these cells developing into cancer was 28%. The risk was highest for a subtype of these cells called atypical ductal hyperplasia (41%), followed by classical lobular neoplasia (29%) and flat epithelial atypia (11%). Only two cases of cancer were detected in the group that was monitored, both of which were associated with atypical ductal hyperplasia.

Based on these findings, the researchers recommend surgical treatment for cases of atypical ductal hyperplasia. For other types of B3 cells, using VABB may be a suitable alternative, provided certain conditions are met. These conditions include ensuring all abnormal cells have been removed by VABB and that the cells do not have high-risk features. The researchers suggest that regular surveillance could be a more suitable management strategy for these cases. The study also suggests that the size of the needle used in the VABB could affect the success of the procedure.

FAQs

  1. What are B3 cells and why are they significant in the study of breast cancer?
  2. What were the findings of the study regarding the treatment of B3 cells, specifically atypical ductal hyperplasia?
  3. What conditions must be met for Vacuum-Assisted Breast Biopsy (VABB) to be considered a suitable alternative to surgical removal of B3 cells?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast biopsy is to follow the recommended treatment plan based on the type of abnormal cells found. In some cases, surgical removal may be necessary to reduce the risk of cancer development, while in other cases, less invasive procedures like vacuum-assisted breast biopsy may be appropriate. Regular surveillance and follow-up appointments are also important to monitor any changes in the breast tissue and ensure early detection of any potential issues. It is important to discuss any concerns or questions with your healthcare provider to ensure the best possible outcome.

Suitable For

Overall, patients who are typically recommended for breast biopsy are those with suspicious breast lumps, abnormal mammogram findings, breast pain, nipple discharge, or skin changes on the breast. Additionally, patients who have a family history of breast cancer, genetic mutations that increase the risk of breast cancer (such as BRCA1 and BRCA2), or a personal history of previous breast cancer may also be recommended for a breast biopsy. It is important for healthcare providers to carefully evaluate each patient’s individual risk factors and symptoms before recommending a breast biopsy to ensure the most appropriate course of action is taken.

Timeline

Before the breast biopsy:

  1. Patient notices a lump or abnormality in the breast during a self-exam or routine screening.
  2. Patient consults with a healthcare provider who recommends a breast biopsy to further investigate the abnormality.
  3. Patient undergoes imaging tests such as a mammogram or ultrasound to locate the abnormality.
  4. Patient may undergo a needle biopsy or core needle biopsy before the decision is made to proceed with a surgical biopsy.
  5. Patient may receive instructions to avoid certain medications before the procedure and may be asked to fast for a period of time.

After the breast biopsy:

  1. Patient undergoes the breast biopsy procedure, either surgical removal or VABB.
  2. Patient may experience some discomfort, bruising, or swelling at the biopsy site after the procedure.
  3. Results of the biopsy are sent to a pathologist for analysis, which may take a few days to a week.
  4. Patient receives the biopsy results from the healthcare provider, which may include a diagnosis of B3 cells.
  5. Patient may be recommended for further treatment based on the type of B3 cells and the risk of developing into cancer.
  6. Patient may undergo regular surveillance or surgical treatment based on the recommendations of the healthcare provider.
  7. Patient may experience emotional distress or anxiety related to the diagnosis and treatment plan.
  8. Patient follows up with healthcare provider for regular check-ups and monitoring of the abnormal cells.

What to Ask Your Doctor

  1. What type of B3 cells do I have, and what is the risk of them developing into cancer?
  2. What are the treatment options for my specific case, and what are the potential risks and benefits of each option?
  3. What are the success rates of VABB compared to surgical removal for cases of B3 cells?
  4. How will the size of the needle used in the VABB procedure impact its effectiveness in removing the abnormal cells?
  5. What criteria need to be met for VABB to be a suitable alternative to surgical removal in my case?
  6. How often will I need to undergo surveillance or follow-up appointments to monitor the potential progression of the B3 cells?
  7. Are there any lifestyle changes or preventive measures I should consider to reduce the risk of the B3 cells developing into cancer?
  8. What are the potential long-term implications of having B3 cells, even if they do not progress into cancer?
  9. Are there any support groups or resources available for individuals with B3 cells or undergoing procedures such as VABB?

Reference

Authors: Lucioni M, Rossi C, Lomoro P, Ballati F, Fanizza M, Ferrari A, Garcia-Etienne CA, Boveri E, Meloni G, Sommaruga MG, Ferraris E, Lasagna A, Bonzano E, Paulli M, Sgarella A, Di Giulio G. Journal: Eur Radiol. 2021 Feb;31(2):920-927. doi: 10.1007/s00330-020-07161-5. Epub 2020 Aug 20. PMID: 32816199