Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00030576.xml
CC BY 4.0 · Rev Bras Ginecol Obstet 2023; 45(04): 215-220
DOI: 10.1055/s-0043-1769468
DOI: 10.1055/s-0043-1769468
Febrasgo Position Statement
Accurate diagnosis of breast lesions
Number 4 – April 2023
Key points
-
Breast lesions comprise a wide variety of diagnoses with different manifestations.
-
Breast lesions can be classified as benign, of uncertain malignant potential (B3), carcinoma in situ, and invasive carcinoma.
-
In the era of personalized medicine, individualizing and getting an accurate diagnosis makes a big difference in the patient’s final outcome, especially in the case of breast cancer.
-
Targeted and quality imaging exams, properly selected biopsy methods and conventional anatomopathology, immunohistochemistry and even molecular analyzes are crucial in the diagnosis and management of patients.
The National Specialized Commission on Breast Imaging of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) endorses this document. Content production is based on scientific evidence on the proposed theme and the results presented contribute to clinical practice.
Publication History
Article published online:
24 May 2023
© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Rageth CJ, O’Flynn EA, Pinker K, Kubik-Huch RA, Mundinger A, Decker T. et al. Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res Treat 2019; 174 (02) 279-96 DOI: 10.1007/s10549-018-05071-1.
- 2 Morrow M, Schnitt SJ, Norton L. Current management of lesions associated with an increased risk of breast cancer. Nat Rev Clin Oncol 2015; 12 (04) 227-38 DOI: 10.1038/nrclinonc.2015.8.
- 3 Forester ND, Lowes S, Mitchell E, Twiddy M. High risk (B3) breast lesions: what is the incidence of malignancy for individual lesion subtypes? A systematic review and meta-analysis. Eur J Surg Oncol 2019; 45 (04) 519-27 DOI: 10.1016/j.ejso.2018.12.008.
- 4 Bennett IC, Saboo A. The evolving role of vacuum assisted biopsy of the breast: a progression from fine-needle aspiration biopsy. World J Surg 2019; 43 (04) 1054-61 DOI: 10.1007/s00268-018-04892-x.
- 5 Huppe AI, Brem RF. Minimally invasive breast procedures: practical tips and tricks. AJR Am J Roentgenol 2020; 214 (02) 306-15 DOI: 10.2214/AJR.19.22082.
- 6 Bhatt AA, Whaley DH, Lee CU. Ultrasound-guided breast biopsies: basic and new techniques. J Ultrasound Med 2021; 40 (07) 1427-43 DOI: 10.1002/jum.15517.
- 7 Pinder SE, Shaaban A, Deb R, Desai A, Gandhi A, Lee AHS. et al. NHS Breast Screening multidisciplinary working group guidelines for the diagnosis and management of breast lesions of uncertain malignant potential on core biopsy (B3 lesions). Clin Radiol 2018; 73 (08) 682-92 DOI: 10.1016/j.crad.2018.04.004.
- 8 Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva. Diretrizes para a detecção precoce do câncer de mama no Brasil. Rio de Janeiro: INCA; 2015.
- 9 Singh D, Singh AK. Role of image thermography in early breast cancer detection- past, present and future. Comput Methods Programs Biomed 2020; 183: 105074 DOI: 10.1016/j.cmpb.2019.105074.
- 10 Hakim A, Awale RN. Thermal imaging – an emerging modality for breast cancer detection: a comprehensive review. J Med Syst 2020; 44 (08) 136 DOI: 10.1007/s10916-020-01581-y.
- 11 Omranipour R, Kazemian A, Alipour S, Najafi M, Alidoosti M, Navid M. et al. Comparison of the Accuracy of Thermography and Mammography in the Detection of Breast Cancer. Breast Care (Basel) 2016; 11 (04) 260-4 DOI: 10.1159/000448347.
- 12 Food and Drug Administration. Breast cancer screening: thermogram no substitute for mammogram [Internet]. 2021 [cited 2022 Jul 10]. Available from: https://www.fda.gov/forconsumers/consumerupdates/ucm257499.htm
- 13 Ambinder EB, Plotkin A, Euhus D, Mullen LA, Oluyemi E, Di Carlo P. et al. Tomosynthesis-guided vacuum-assisted breast biopsy of architectural distortion without a sonographic correlate: a retrospective review. AJR Am J Roentgenol 2021; 217 (04) 845-54 DOI: 10.2214/AJR.20.24740.
- 14 American Society of Breast Surgeons. Consensus guideline on image-guided percutaneous biopsy of palpable and nonpalpable breast lesions. Columbia: ASBS; 2017
- 15 Teberian I, Kaufman T, Shames J, Rao VM, Liao L, Levin DC. Trends in the use of percutaneous versus open surgical breast biopsy: an update. J Am Coll Radiol 2020; 17 (08) 1004-10 DOI: 10.1016/j.jacr.2020.02.015.
- 16 Camargo Júnior HS, Camargo MM, Teixeira SR, Arruda MS. Biópsia de fragmento em nódulos mamários suspeitos com até 10 mm. Rev Bras Ginecol Obstet 2007; 29 (06) 317-23 DOI: 10.1590/S0100-72032007000600007.
- 17 Park HL, Kim KY, Park JS, Shin JE, Kim HR, Yang B. et al. Clinicopathological analysis of ultrasound-guided vacuum-assisted breast biopsy for the diagnosis and treatment of breast disease. Anticancer Res 2018; 38 (04) 2455-62 DOI: 10.21873/anticanres.12499.
- 18 Agência Nacional de Saúde Suplementar. Rol de procedimentos e eventos em saúde: Anexo II – Diretrizes de utilização para cobertura de procedimentos na saúde suplementar [Internet]. Brasília (DF): ANS; 2016. [cited 2022 Jul 10]. Available from: http://www.ans.gov.br/images/stories/Plano_de_saude_e_Operadoras/Area_do_consumidor/rol/rol2016_diretrizes_utilizacao.pdf
- 19 Povoski SP, Jimenez RE, Wang WP. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach. World J Surg Oncol 2011; 9: 87 DOI: 10.1186/1477-7819-9-87.
- 20 Boufelli G, Giannotti MA, Ruiz CA, Barros N, Chala LF, Maesaka JY. et al. Papillomas of the breast: factors associated with underestimation. Eur J Cancer Prev 2018; 27 (04) 310-4 DOI: 10.1097/CEJ.0000000000000343.
- 21 McMahon MA, Haigh I, Chen Y, Millican-Slater RA, Sharma N. Role of vacuum assisted excision in minimising overtreatment of ductal atypias. Eur J Radiol 2020; 131: 109258 DOI: 10.1016/j.ejrad.2020.109258.
- 22 Bennett IC. The changing role of vacuum-assisted biopsy of the breast: a new prototype of minimally invasive breast surgery. Clin Breast Cancer 2017; 17 (05) 323-5 DOI: 10.1016/j.clbc.2017.03.001.
- 23 Brennan ME, Turner RM, Ciatto S, Marinovich ML, French JR, Macaskill P. et al. Ductal carcinoma in situ at core-needle biopsy: meta-analysis of underestimation and predictors of invasive breast cancer. Radiology 2011; 260 (01) 119-28 DOI: 10.1148/radiol.11102368.