Varga Zsuzsanna, Sinn Peter, Lebeau Annette
Institut für Pathologie und Molekularpathologie, Universitätsspital Zürich, Schmelzbergstr. 12, 8091, Zürich, Schweiz.
Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
Pathologie (Heidelb). 2023 Feb;44(1):5-16. doi: 10.1007/s00292-022-01180-3. Epub 2023 Jan 12.
B3 lesions of the breast are a heterogeneous group of lesions with uncertain malignant potential encompassing a broad spectrum of histologically distinct alterations that often pose challenging decisions if diagnosed on the preoperative core or vacuum biopsies. B3 lesions are mostly detected due to mammographic calcifications or mass lesions and, in most cases, encompass a spectrum of atypical lesions such as atypical ductal hyperplasia, classic lobular neoplasia, flat epithelial atypia, papillomas, fibroepithelial tumors, and rarely other lesions such as mucocele-like lesions, atypical apocrine lesions, and rare stromal proliferations. The use of immunohistochemical stains (estrogen receptors, basal cytokeratin, myoepithelial markers, and stromal marker panel) is useful in the differentiation of these lesions and allowing proper classification. Regarding clinical management of B3 lesions, the radiological-pathological correlation of the given entity plays the most important key element for the proper next diagnostic and therapeutic step.
乳腺B3病变是一组异质性病变，其恶性潜能不确定，包括一系列组织学上不同的改变，如果在术前粗针活检或真空辅助活检中诊断出来，常常会带来具有挑战性的决策。B3病变大多因乳腺钼靶钙化或肿块病变而被检测到，在大多数情况下，包括一系列非典型病变，如非典型导管增生、经典小叶肿瘤、扁平上皮不典型增生、乳头状瘤、纤维上皮肿瘤，很少有其他病变，如黏液囊肿样病变、非典型大汗腺病变和罕见的间质增生。使用免疫组织化学染色（雌激素受体、基底细胞角蛋白、肌上皮标志物和间质标志物组合）有助于区分这些病变并进行正确分类。关于B3病变的临床管理，特定实体的放射学-病理学相关性是正确进行下一步诊断和治疗的最重要关键因素。
