{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:35:22Z","timestamp":1792895722060,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>UK guidelines for indeterminate (B3) breast lesions recommend vacuum-assisted excision (VAE) over diagnostic surgery. However, there is little long-term follow-up published post VAE management. This study evaluates immediate and long-term outcomes of women with B3 lesions managed predominantly through radiological pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-centre retrospective review of B3 lesions diagnosed between October 2011 and August 2017, evaluating outcomes following immediate management and subsequent breast cancer development during follow-up until February 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>513 women (median age, 53\u2009years) were diagnosed with B3 lesions between October 2011 and August 2017. 391 (76.2%) had radiological management with second-line VAE, 48 (9.4%) had diagnostic excision and 74 (14.4%) had no second-line procedure. 54 lesions (10.5%) were upgraded to malignancy. Yearly mammography (atypia lesions, 5\u2009years) or 3-yearly screening (non-atypia lesions) was offered to the remaining 459 women. 44\/459 (9.6%) women had no mammographic follow-up (patient decision).<\/jats:p>\n                    <jats:p>Breast cancer occurred in 33 patients (7.2%), the majority (23\/33, 69.7%) detected during imaging surveillance. 10 cancers (30.3%) occurred at the original B3 site. 5-year cumulative incidence of breast cancer was 6.3% (95% CI, 3.9%-8.7%). No significant difference in 5-year cumulative incidence of breast cancer between women with atypia (7.8%; 95% CI, 4.3%-11.2%) or without atypia (4.3%; 95% CI, 1.1%-7.4%) was demonstrated (P\u2009=\u2009.375).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Radiological management of B3 lesions is safe and effective. Following initial management, women with B3 lesions have a small risk of subsequent breast cancer, similar for lesions with or without atypia, most of which could be safely managed within normal screening pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>Vacuum-assisted excision can safely and effectively manage appropriate indeterminate breast lesions.<\/jats:p>\n                    <jats:p>Risk of breast cancer following B3 diagnosis is low<\/jats:p>\n                    <jats:p>No statistically significant difference in subsequent breast cancer risk was demonstrated between B3 lesions with and without atypia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag246","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:24:41Z","timestamp":1791563081000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of indeterminate breast (B3) lesions managed with vacuum-assisted excision"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8343-4682","authenticated-orcid":false,"given":"Nerys D","family":"Forester","sequence":"first","affiliation":[{"name":"Newcastle University , Newcastle upon Tyne, NE1 7RU,","place":["United Kingdom"]},{"name":"Department of Breast Screening and Assessment, Newcastle Upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne, NE1 4LP,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hina","family":"Faisal","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hull University Teaching Hospitals NHS Trust , Hull, HU3 2JZ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S","family":"Pearce","sequence":"additional","affiliation":[{"name":"Newcastle University Population Health Sciences Institute , Newcastle, NE2 4AX,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5727-8041","authenticated-orcid":false,"given":"Nigel W","family":"Gummerson","sequence":"additional","affiliation":[{"name":"Centre for Neurosciences, Leeds General Infirmary , Leeds, LS1 3EX,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"2026102422321311900_tqag246-B1","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1056\/NEJMra035692","article-title":"Benign breast disorders","volume":"353","author":"Santen","year":"2005","journal-title":"N Engl J Med"},{"key":"2026102422321311900_tqag246-B2","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.breast.2006.06.009","article-title":"Breast core biopsy reporting categories-an internal validation in a series of 3054 consecutive lesions","volume":"16","author":"Andreu","year":"2007","journal-title":"Breast"},{"key":"2026102422321311900_tqag246-B3","volume-title":"National Breast Screening Pathology Audit 2015. 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