B3 Breast Lesions and Excisional Biopsies

Who is at Risk?

The exact cause of B3 lesions is unknown, and anyone can develop them. However, certain risk factors may increase the likelihood:

• Age – More common in women over 40.

• Hormonal Factors – Some hormonal changes may play a role in the development of B3 lesions.

• Family History – Women with a family history of breast cancer may have a higher risk.

B3 breast lesions include several different types of tissue changes, such as:

• Atypical Ductal Hyperplasia (ADH) – Abnormal growth of cells within the milk ducts.

• Lobular Neoplasia (LN) – Abnormal cells in the lobules, also called atypical lobular hyperplasia or lobular carcinoma in situ (LCIS).

• Papillomas – Small, wart-like growths inside the ducts, sometimes containing abnormal cells.

• Radial Scars (Complex Sclerosing Lesions) – Star-shaped areas of scar-like tissue.

• Flat Epithelial Atypia (FEA) – Abnormal cells lining the ducts.

These findings are often detected during routine mammograms or other breast imaging tests and confirmed by biopsy.

How Are B3 Lesions Diagnosed?

B3 lesions are usually detected during imaging tests, often before any symptoms appear. The diagnosis process includes:

1. Mammogram or Ultrasound – B3 lesions may appear as suspicious areas on a mammogram or ultrasound.

2. Core Needle Biopsy – A tissue sample is taken from the suspicious area to confirm whether the lesion is B3.

3. Pathology Analysis – A pathologist examines the biopsy sample to determine the exact type of lesion and assess the presence of any abnormal or atypical cells.

Management and Treatment Options for B3 Lesions

Treatment for B3 lesions varies depending on the lesion type, size, and the presence of any atypical or abnormal cells. Options include:

1. Surgical Excision

• Surgical removal (excision) of the lesion may be recommended to ensure all atypical cells are removed and to check for any signs of early cancer in the surrounding tissue. This is often the case for lesions with higher risk features, such as atypical ductal hyperplasia or lobular neoplasia.

2. Close Monitoring (Surveillance)

• In cases where the B3 lesion has low-risk features, close monitoring may be an option. This includes regular imaging tests, such as mammograms or MRIs, and follow-up clinical exams. Monitoring is usually done every 6 to 12 months.

3. Hormone Therapy

• For some patients, especially those with lobular neoplasia, hormone therapy (e.g., tamoxifen) may be considered to help reduce the risk of developing breast cancer. This option is often discussed if there are additional risk factors.

Follow-Up Care

Follow-up care is important for managing B3 lesions. Your healthcare provider will develop a personalized follow-up plan that may include:

• Regular Imaging Tests – Routine mammograms or other imaging to monitor for changes.

• Physical Exams – Clinical breast exams to check for any new lumps or changes.

• Discussion of Lifestyle Factors – Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and limiting alcohol, may help reduce risk.

Living with a B3 Lesion Diagnosis

A B3 lesion diagnosis can be concerning, but it’s important to remember that these lesions are not cancer. However, staying proactive with follow-up care is essential to detect any changes early. Many people with B3 lesions never develop breast cancer, but regular monitoring is essential.