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Abstract
Introduction. Breast lesions of pathomorphological category B3 are a heterogeneous group with an uncertain malignancy potential. With the widespread use of vacuum-assisted biopsy (VAB) in Russia, including for B3 lesions, the question of the advisability of placing a clip at the site of intervention becomes relevant.
Materials and Methods. The study included 248 women who presented to the N.N. Petrov NMRC of Oncology in 2020-2023 with breast lesions detected by MG, US, MRI. They were divided into three groups based on the results of visualization and histological verification: group 1 (n = 140) — a lesion of pathomorphological category B2 with radiological features of BI-RADS 2; group 2 (n = 25) — a lesion of pathomorphological category B3 with radiological features of BI-RADS 3 or BI-RADS 4a; group 3 (n = 83) — a lesion of pathomorphological category B2 with radiological features of BI-RADS 4a or higher. All patients underwent ultrasound-guided VAB. No clip was placed after VAB in group 1. A clip was placed after VAB in groups 2 and 3. The biopsies were subjected to histological and, if necessary, immunohistochemical analysis.
Results. The histological findings from CNB were compared with complete excision of the target area via VAB. The analyzis showed complete agreement: CNB vs. VAB in group 1 (all fibroadenomas). Group 2 showed the most discrepancies: breast cancer (BC) was detected after VAB in 9 cases (5 DCIS, 4 NST). Group 3 also showed diagnostic discrepancies after VAB: 6 patients were diagnosed with BC (4 DCIS, 1 NST, 1 ILC). In 108 cases, clips were placed at the VAB site, 15 located areas where BC was detected.
Conclusion. Placement of a metal clip at the site of VAB is required for category B3 lesions and in cases of discordance between radiological and histological findings. This approach greatly enhances the monitoring of the interventional area and facilitates more appropriate surgical management when ВС is confirmed.
References
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