Radiological Features of B3 Lesions in Mutation Carrier Patients: A Single-Center Retrospective Analysis

Abstract

Background. To evaluate the radiological features of B3 lesions in patients with genetic mutations to establish an anatomo-radiological correlation. Methods. A total of 227 women with a histological diagnosis of B3 breast lesion were enrolled. Breast images of 21 patients with genetic test positivity for mutations in genes associated with breast cancer were analyzed. Results. BRCA1 was the most frequent mutation (n = 12) followed by ATM (n = 6) and BRCA2 (n = 3). The histological findings showed nine atypical ductal hyperplasia (ADH), six lobular neoplasia (LN) including lobular carcinoma in situ (LCIS), three flat epithelial atypia (FEA) and three radial scar (RS) lesions. The results showed a significance difference between B3 lesion distribution in the three subgroups of mutations. LN and FEA showed the highest malignancy correlation. Patient age and risk anamnesis were factors that significantly influenced the malignancy rate. By mammography, 90.5% of lesions appeared as microcalcifications. By ultrasound, 13 lesions were observed as hypoechoic lesions. On breast MRI, 16 lesions were detected as a mass enhancement in all groups. DWI and kinetic curves significantly correlated with the risk of cancer. Conclusions. The radiological features of B3 lesions may help in the diagnosis of breast cancer malignancy. The high malignancy rate of cancer in our sample suggests they should always be surgically excised.