2. Consultant Breast Pathologist. Frimely Health NHS Foundation Trust, UK.
Purpose: Papillary lesions with no atypia (PLNA) are breast lesions with unknown potential of malignancy (B3). New B3 guidelines published in 2018 by NHS Breast Screening Programme proposed VAE (vacuum assisted excision) of PLNA as an alternative to open surgical excision. This study aims to summarise our results using ultrasound guided VAE as diagnostic and therapeutic tool for PLNA, as well as to demonstrate how the technique works and describe the patient experience.
Material and Methods: Retrospective analysis of the US guided VAE (7G needle) for treatment of PLNA since July 2018. We reviewed the procedure, time taken, technical specifications, potential complications and the results.
Results: Twenty one PLNA were excised. The size of the lesions was 5- 28 mm. Eighteen of the lesions were completely excised. In 16 of the lesions a post biopsy clip was inserted.
The procedure lasted an average of 30 minutes (including consenting and positioning). During and after the procedure there were no complications.
Twenty of the excised lesions came back as papillary lesions with no atypia. One of the lesions was up graded to atypical ductal hyperplasia. None of them were upgraded to B5 lesions.
Conclusion: Ultrasound guided VAE could be used as first line treatment or diagnosis of papillary lesions with no atypia. The procedure is simple and easy to perform with no complications. In the majority of the cases the lesion can easily be removed completely.
Keywords: Breast, Papillary lesion, Papilloma, No atypia, VAE, Ultrasound, B3, Upgrade, Excision, Unkown potential of malignancy, Screening