EP 678 A Retrospective Audit of Surveillance Practices of Screen-Detected B3 Lesions in a Tertiary Breast Unit
Chien Lin Soh, Ken Ho, Daniel LeffAbstract
Background
Surveillance of breast lesions with uncertain malignant potential (B3) detected through the NHS breast screening programme (NHSBSP) has been updated. Previous guidelines recommended five-year annual mammography for screen-detected B3 lesions with atypia post-excision - latest guidance replaces this with a return to routine screening. Aims: This audit retrospectively evaluates a breast unit’s practice regarding screen-detected B3 lesions to determine the impact of the new guidance.
Methods
This registered audit (PLA_54) involved data collection including B3 lesion histopathology and surveillance from electronic records (Cerner) from 1 January to 31 October 2025.
Results
Prior to the new NHSBSP guidelines, 69 patients with a mean age of 58.9 ± 6.55 years were identified as having screen-detected B3 lesions. 13 patients were excluded from the analysis after vacuum-assisted/surgical excision – 5 patients had cancer and 8 patients self-discharged. Of 56 patients, 53 patients had a vacuum-assisted excision and 3 patients had surgery. Most common initial diagnosis was intraductal papilloma (n=14), complex sclerosing lesion (n=13) and atypical intraductal epithelial proliferation (n=8). 64% (36/56) of patients were referred for five-year annual mammograms. Concordance to mammographic surveillance referrals in the previous NHSBSP guidelines was at 86% (48/56, p>0.05). With the new guidance, 57% (32/56) of patients would not meet the requirements for five-year mammographic surveillance – with a mammographic cost reduction of £288/patient.
Conclusion
Adherence to historical NHSBSP guidance about annual five-year mammographic surveillance in our tertiary unit prior to introduction of the new guidelines was 86%. Our practice will be re-audited after an educational intervention.