Guidelines

Vol. 117: Issue 3 - June 2025

Consensus document on preoperative diagnostic procedures in breast lesions

Authors

Stefano Marletta , Isabella Castellano , Francesca Caumo , Carmen Criscitiello , Patrizia Frittelli , Donatella Santini , Daniela Terribile , Daniela Bernardi , Marina Bortul , Massimo Calabrese , Giuseppe Catanuto , Maria Grazia Cattani , Leopoldo Costarelli , Giulia D’Amati , Nicola Fusco , Oreste Gentilini , Moira Ragazzi , Gianni Saguatti , Alfredo Santinelli , Cristian Scatena , Grazia Sciancalepore , Francesca Pietribiasi , Anna Sapino , Antonio Rizzo

Key words: preoperative biopsy, breast cancer, consensus, multidisciplinary management
DOI: 10.32074/1591-951X-1113
Publication Date: 2025-07-04

Abstract

Currently, percutaneous sampling via core needle or vacuum-assisted biopsy is the primary choice to guide the management of patients with clinical or screen-detected breast lesions. Preoperative biopsies allow physicians to get pathological diagnoses as well as key prognostic and predictive data about the nature of the investigated process. Namely, adequate biopsy sampling is crucial for assigning lesions to one diagnostic category (B1- B5). Similarly, evaluating morphological (histotype, vascular invasion, necrosis, etc.) and immunohistochemical/molecular features (ER, PR, Ki-67, and HER2) is the key to address the most effective therapies, especially in the neoadjuvant setting. The multidisciplinary team should always discuss the results of percutaneous biopsies, whose global integration with clinical and radiological findings will drive the adoption of specific treatment options, particularly for uncertain (B3) and suspicious/malignant (B4-B5) lesions. In the present work, we report a comprehensive overview of breast percutaneous biopsy techniques, diagnostic categories, and multidisciplinary management based on widely acknowledged evidence of good clinical practice

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Authors

Stefano Marletta - Division of Pathology, Humanitas Istituto Clinico Catanese, Catania, Italy; Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Italy

Isabella Castellano - Department of Medical Sciences, University of Turin, Italy

Francesca Caumo - Veneto Institute of Oncology (IOV) IRCCS, Padua, Italy

Carmen Criscitiello - Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy

Patrizia Frittelli - UOC Chirurgia senologica, Ospedale Isola Tiberina Gemelli Isola, Rome, Italy

Donatella Santini - Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

Daniela Terribile - Division of Breast Surgery, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy

Daniela Bernardi - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy; Breast Imaging and Screening Unit, Department of Radiology, IRCCS Humanitas Research Hospital, Milan, Italy

Marina Bortul - SSD Breast Unit, ASUGI Units, Trieste, Italy

Massimo Calabrese - IRCCS Hospital Policlinico San Martino, Genoa, Italy

Giuseppe Catanuto - Humanitas University Istituto Clinico Catanese, Catania, Italy

Maria Grazia Cattani - Unit of Anatomic Pathology, AUSL Bologna, Ospedale Bellaria, Bologna, Italy

Leopoldo Costarelli - Department of Pathology, San Giovanni-Addolorata Hospital, Rome, Italy

Giulia D’Amati - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Italy

Nicola Fusco - Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy

Oreste Gentilini - Università Vita-Salute San Raffaele, Milano, Italy

Moira Ragazzi - Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Italy; Department of Medical and Surgical Sciences for Children and Adults University of Modena and Reggio Emilia, Modena, Italy

Gianni Saguatti - UO Senologia, Ospedale Bellaria, AUSL Bologna, Italy

Alfredo Santinelli - UOC Anatomia Patologica, Azienda Sanitaria Territoriale di Pesaro-Urbino, Pesaro, Italy

Cristian Scatena - 24 Division of Pathology, Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy; Department of Oncology, Pisa University Hospital, Pisa, Italy

Grazia Sciancalepore - ASO “S. Croce e Carle”, Cuneo, Italy

Francesca Pietribiasi - Division of Pathology, Santa Croce Hospital, Moncalieri, Turin, Italy

Anna Sapino - Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy; Department of Medical Sciences, University of Turin, Italy

Antonio Rizzo - Division of Pathology, Humanitas Istituto Clinico Catanese, Catania, Italy

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Copyright

Copyright (c) 2025 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology

How to Cite
Marletta, S., Castellano, I., Caumo, F., Criscitiello, C., Frittelli, P., Santini, D., Terribile, D., Bernardi, D., Bortul, M., Calabrese, M., Catanuto, G., Cattani, M. G., Costarelli, L., D’Amati, G., Fusco, N., Gentilini, O., Ragazzi, M., Saguatti, G., Santinelli, A., Scatena, C., Sciancalepore, G., Pietribiasi, F., Sapino, A., & Rizzo, A. (2025). Consensus document on preoperative diagnostic procedures in breast lesions. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 117(3). https://doi.org/10.32074/1591-951X-1113
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