Search Results (65)

Background/Objectives: Lipedema is a chronic, progressive adipo-fascial disorder characterized by connective tissue dysfunction, fibrosis, microangiopathy, and adipose tissue proliferation. Although lipedema has traditionally been described as a regionally confined disorder, emerging evidence suggests that it may reflect a broader stromal and connective tissue dysfunction. It is therefore plausible that anatomical regions not historically associated with lipedema may also exhibit alterations consistent with this dysfunctional stromal pattern. From this perspective, breast tissue—rich in fibro-glandular and stromal components—represents a compelling model in which to investigate whether such features are present. The breast, with its complex fibro-glandular and stromal architecture, represents a physiologically plausible site of involvement; however, its structural features in lipedema have never been systematically examined. The primary aim of this study was therefore to determine whether breast tissue—rich in fibro-glandular and stromal components—shows recurrent imaging or histopathological features suggestive of lipedema-related involvement. A secondary aim was to compare the frequency of these findings with patterns typically reported in healthy screening populations. Methods: This retrospective cross-sectional study analyzed 62 women (mean age: 44 ± 8 years), obtained between September and November 2025, with a clinical diagnosis of lipedema who voluntarily provided breast imaging reports (ultrasound, mammography, or magnetic resonance imaging, MRI). Results: The findings revealed a remarkably high prevalence of fibro-glandular parenchyma (45%), multiple diffuse cysts (42%), microcalcifications (21%), and fibroadenomas (43.5%), with frequencies substantially exceeding those documented in healthy screening populations. Additional features included significant breast asymmetry or tuberous morphology (6%), reactive or sclero-lipomatous lymph nodes (19%), and recurrent stromal hyperplasia on biopsy. Histological evaluations (n = 9) consistently showed fibroproliferative alterations, including stromal hypercellularity, adenosis, fibroepithelial lesions, apocrine metaplasia, and pseudoangiomatous stromal hyperplasia, suggesting a shared extracellular matrix-related dysplastic phenotype between lipedema-affected breast tissue and peripheral adipose tissue. Conclusions: These findings support the hypothesis that lipedema may express a characteristic breast phenotype driven by stromal and extracellular matrix dysregulation. If confirmed in larger controlled studies, these recurrent alterations could contribute to improved diagnostic frameworks and raise awareness of lipedema as a systemic connective tissue disorder with underrecognized breast manifestations. Full article

Background: The diagnostic process for probable benign breast lesions involves a 1–40% upgrade rate to malignancy when biopsy (cytology and/or histology) is compared with surgery. In a previously conducted clinical randomized trial, we aimed to examine diagnostic discrepancies between prior biopsy results and subsequent vacuum-assisted excision (VAE). Methods: This study is a post hoc analysis of the Swedish VAE randomized trial. Patients were enrolled between November 2019 and August 2022. All patients who underwent a biopsy before VAE were included in this study. Pathology reports from the initial biopsy, VAE, surgical excision, and recurrence were collected. In addition, we conducted clinical follow-up, including imaging, for at least 2 years. Results: The study population included 169 patients with 169 lesions, of whom 71 underwent fine-needle aspiration cytology (FNA), and 126 underwent core-needle biopsy (CNB) before VAE. The diagnostic discrepancy between FNA and VAE was 38% (27/71). The discrepancy between CNB and VAE was 29% (37/126). The upgrade rate to cancer was 7% (5/71) for FNA and 5% (6/126) for CNB. In the CNB group, the highest upgrade rate to cancer occurred in patients with prior atypical ductal hyperplasia (ADH) on CNB (3/12, 25%). Conclusions: The upgrade rate in histopathological diagnosis between prior CNB and VAE was high (15%), and even higher when comparing FNA with VAE (24%). Our findings support avoiding FNA for BI-RADS 3 and 4a lesions and suggest that multi-round VAE may be a safe and effective alternative to surgery for selected cases, particularly those with ADH on CNB. Full article

Mastitis is a common mammary gland disease in mammals that severely impairs lactation function, with Staphylococcus aureus (S. aureus) being the primary pathogenic bacterium. However, the molecular mechanisms underlying S. aureus-induced mastitis in sheep remain incompletely elucidated. This study employed RNA sequencing (RNA-SEq) technology to systematically analyze the dynamic transcriptomic characteristics of mammary tissue in small-tailed sheep (SHT) after S. aureus infection, aiming to clarify the molecular regulatory mechanism of the host immune response and its relationship with the occurrence of mastitis. Twelve lactating STH were selected to establish an S. aureus-induced mastitis model. Blood, milk, and tissue samples were collected at 0, 24, 48, and 72 h post-infection (hpi). The infected sheep exhibited typical mastitis symptoms, including exacerbated breast swelling, reduced milk yield, elevated udder temperature, and darker, more viscous milk. Hematoxylin–eosin (HE) staining revealed significant pathological changes over time, such as stromal hyperplasia, extensive inflammatory cell infiltration, severe necrosis and sloughing of mammary epithelial cells, and compromised tissue integrity. RNA-Seq analysis identified 1299 differentially expressed genes (DEGs), among which 75 core genes maintained stable expression throughout the infection time (24 hpi, 48 hpi, and 72 hpi). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses indicated that these DEGs were associated with metabolic processes, protein binding, Toll-like receptor signaling, and the NF-κB pathway. The PPI network analysis identified core hub genes including PTK2B, STAT3, and JAK1/3, providing critical evidence for therapeutic target screening. Furthermore, qPCR verification indicated that the expressions of innate immune receptors TLR2, TLR4, TLR7, and TLR10, as well as pro-inflammatory factors IL-1β, IL-16, TNF-α, type I interferon (IFN-α), and nuclear transcription factor NF-κB were significantly upregulated in a time-dependent manner (p < 0.05). In conclusion, this study delineated the dynamic response of ovine mammary tissue to S. aureus infection, systematically elucidated temporal gene expression patterns, and revealed the molecular mechanisms underlying the tissue’s initial defense against inflammatory challenges. Full article

Endometrial hyperplasia, presenting without atypia (EH) or as atypical hyperplasia (AH), is considered a precursor of endometrial cancer and affects women of reproductive or perimenopausal age, posing a major public health concern. The aim of this study was to review and compare the most recently published influential guidelines providing recommendations on the management of endometrial hyperplasia. Thus, a comparative review of guidelines from the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynecologists of Canada, and the American College of Obstetricians and Gynecologists was conducted. There is a consensus regarding the optimal management strategies for EH, with observation and medical treatment being the first-line options and surgical treatment with total hysterectomy offering a second line in specific cases. Moreover, there is agreement regarding patients with AH, with surgical treatment being the recommended approach, while medical therapy is preferred for women who seek fertility preservation. Notably, close surveillance with endometrial biopsies every 3 or 6 months is suggested unanimously, as well as long-term follow-up in high-risk patients. Controversy exists regarding the initial diagnostic approach, with RCOG and SOGC suggesting outpatient endometrial biopsy, while ACOG recommends diagnostic hysteroscopy, as well as the therapeutic regimens for the oral treatment of EH. Surgical techniques such as endometrial ablation, intraoperative frozen section analysis, intraoperative visual inspection of the uterus, and morcellation constitute areas of controversy among the reviewed guidelines, and the surveillance protocols for women with EH are addressed differently between RCOG and SOGC. Notably, RCOG is the only medical society offering recommendations regarding women under HRT and those on therapy for breast cancer. The development of consistent international practice protocols for timely management strategies and surveillance protocols is of paramount importance to safely guide clinical practice and subsequently improve women’s health. Full article

Introduction: Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast lesion characterized by stromal myofibroblast proliferation forming slit-like pseudoangiomatous spaces. Although most frequently diagnosed in premenopausal women, it has also been reported in adolescent girls, where it may present as a rapidly enlarging mass that mimics fibroadenoma or phyllodes tumor. The pathogenesis is thought to be hormonally influenced, particularly by progesterone, with a possible role for estrogen. Case Report: We report the case of a 14-year-old girl who presented with a painless, rapidly growing mass in the left breast, first noticed approximately six months earlier. Clinical examination revealed a mobile lesion about 10 cm in diameter without skin changes, lymphadenopathy, or nipple discharge. Ultrasound and MRI demonstrated a large, well-circumscribed solid tumor (10.4 × 11.2 × 4.2 cm³) displacing normal breast tissue but without infiltration; both were classified as BI-RADS 4. Given the tumor size, diagnostic uncertainty, and potential risk of a non-representative core needle biopsy, a decision was made to proceed with primary radical excision. The mass was completely removed with preservation of the glandular tissue. Histopathology confirmed PASH, described macroscopically as a solid, gray–yellow, encapsulated tumor and microscopically as slit-like spaces lined by spindle cells (CD34+, CD31–). Postoperatively, the breast gradually regained symmetry with the contralateral side, and at 14 months of follow-up, no recurrence was observed. Conclusions: PASH, although benign, may present as a large breast tumor in adolescents and clinically mimic both benign and malignant lesions. Histological evaluation based on an adequately performed biopsy is crucial for accurate diagnosis. Complete excision with capsule preservation is recommended to minimize the risk of recurrence. In adolescents, a watchful waiting approach after surgery may be beneficial, as breast tissue often remodels and regains symmetry spontaneously, reducing the need for reconstructive procedures. This case underscores the importance of individualized diagnostic and therapeutic strategies in managing rare benign breast lesions in pediatric patients. Full article

Mammary tumors occur in female and male guinea pigs. However, published data on their histology and sex predispositions are limited. Histologically, we examined proliferative mammary lesions of 69 female and 48 male pet guinea pigs. Lobular hyperplasia was observed only in females (n = 50). Benign tumors included simple adenomas (n = 20), adenolipomas (n = 3) and intraductal papillary adenomas (n = 5). All except two intraductal papillary adenomas occurred in females. Most malignancies were tubulopapillary and solid carcinomas (n = 54), and intraductal papillary carcinomas (n = 13). These were diagnosed more frequently in male (n = 41) than in female (n = 26) guinea pigs. The carcinomas of males had higher mitotic counts than those of females (p = 0.05). Three carcinosarcomas developed in adenolipoma, and one arose in adenoma. Results show that the mammary tumor classification of dogs and cats can be applied to guinea pigs. However, some tumors (adenolipoma, metaplastic carcinoma) are unique to guinea pigs and shared with laboratory rodents and humans, respectively. Benign tumors may undergo malignant progression. Male guinea pigs appear predisposed to ductal-associated and malignant tumors. Data suggest that male guinea pigs represent an animal model for human male breast cancer. Full article

This article profiles 27 innovative advancements in small-molecule drugs approved by the U.S. Food and Drug Administration (FDA) in 2024. These drugs target various therapeutic areas including non-small cell lung cancer, advanced or metastatic breast cancer, glioma, relapsed or refractory acute leukemia, urinary tract infection, Staphylococcus aureus bloodstream infections, nonalcoholic steatohepatitis, primary biliary cholangitis, Duchenne muscular dystrophy, hypertension, anemia due to chronic kidney disease, extravascular hemolysis, primary axillary hyperhidrosis, chronic obstructive pulmonary disease, severe alopecia areata, WHIM syndrome, Niemann–Pick disease type C, schizophrenia, supraventricular tachycardia, congenital adrenal hyperplasia, and cystic fibrosis. Among these approved small-molecule drugs, those with unique mechanisms of action and designated as breakthrough therapies by the FDA represent a significant proportion, highlighting ongoing innovation. Notably, eight of these drugs (including Rezdiffra^®, Voydeya^®, Iqirvo^®, Voranigo^®, Livdelzi^®, Miplyffa^®, Revuforj^®, and Crenessity^®) are classified as “first-in-class” and have received breakthrough therapy designation. These agents not only exhibit distinct mechanisms of action but also offer substantial improvements in efficacy for patients compared to prior therapeutic options. This article offers a comprehensive analysis of the mechanisms of action, clinical trials, drug design, and synthetic methodologies related to representative drugs, aiming to provide crucial insights for future pharmaceutical development. Full article

The “angiogenesis switch”—defined as the active process by which solid tumors develop their own circulation—plays an important role in both tumoral growth and propagation. As the malignant tumor grows and reaches a critical size, the metabolic needs as a function of an ever-increasing distance to the nearest emergent blood vessel, can no longer be covered by the microenvironment of the peritumoral tissue. Although a relatively discrete process, the “angiogenic switch” acts as a limiting stage of tumoral development present from the avascular hyperplasia phase to the vascularized neoplastic phase, providing support for tumor expansion and metastasis. Over time, research has focused on blocking the angiogenetic pathways (such as VEGF/VEGFR signaling axis) leading to the development of targeted therapeutic agents such as Bevacizumab. Objectives: We conducted a review of the molecular principles of tumoral angiogenesis and we tried to follow the history of Bevacizumab from its first approval for human usage 20 years ago to current days, focusing on the impact this agent had in solid tumor therapy. A comprehensive review of clinical trials pertaining to Bevacizumab (from the era of the preclinic trials leading to approval for human usage, to the more recent randomized trial focusing on combination targeted therapy) further details the role of this drug. We aimed to establish if this ancient drug continues to have a place in modern oncology. Conclusions: Bevacizumab, one of the first drugs targeting tumoral microenvironment, remains one of the most important oncologic agents blocking the VEGF/VEGFR angiogenic pathway. otherwise, history of 20 years marked by numerous controversies (ranging from methodological errors of clinical trials to withdrawal of approval for human usage in breast cancer patients, from discussions about severe side effects to resistance to therapy and limited efficacity), Bevacizumab continues to provide an optimal therapeutic option for many solid tumors that previously had little to no means of treatment, improving otherwise bleak outcomes. Even in the era of personalized precision oncology, Bevacizumab continues to be a key element in many therapeutic regimens both as monotherapy and in combination with newer targeted agents. Full article

Background: B3 lesions of the breast, for which vacuum-assisted biopsy (VABB) represents the standard tissue sampling approach, have different risks of upgrade to malignancy at surgery and/or follow-up. This study aimed to investigate if complete or partial lesion removal during VABB of B3 lesions presenting as microcalcifications influences their subsequent upgrade rate. Methods: For this retrospective single-center study, we retrieved 165 lesions diagnosed as B3 at VABB that presented solely as microcalcifications categorized as Breast Imaging Reporting & Data System (BI-RADS) 4 or 5 at mammography between January 2016 and December 2020. Surgical pathology or at least 3-year follow-up were obtained to determine potential lesion upgrade to malignancy. χ², Fisher’s, and Mantel–Haenszel tests were performed to assess if complete lesion removal influenced upgrade rates overall and among different B3 subtypes. Results: Complete lesion removal was achieved in 99/165 cases (60.0%) and did not differ among B3 subtypes (p = 0.092). The overall upgrade rate was 8.5% (95% confidence interval [CI] 5.1–13.7%, 14/165), without statistically significant differences among B3 subtypes (p = 0.562). Conversely, completely removed lesions (4.0%, 95% CI 1.6–9.9%) had a statistically significant lower upgrade rate compared to partially removed lesions (15.2%, 95% CI 8.4–25.7%, p = 0.019). According to stratified analysis according to B3 subtypes, the odds ratio of upgrade among completely and partially removed flat epithelial atypia (0.13, 95% CI 0.00–1.45) was lower (Mantel-Haenszel test p = 0.016) than those of atypical ductal hyperplasia (0.31, 95% CI 0.02–3.17) and of lobular neoplasia (0.73, 95% CI 0.01–60.62). Conclusions: The upgrade rate of B3 lesions is significantly influenced by complete lesion removal, both overall and among different B3 subtypes. Full article

Background and Objectives: Postmenopausal women are often treated with exogenous female hormones to alleviate physical symptoms and support mental health. We posit that women treated with estrogen fare better following burn injury. Materials and Methods: De-identified patient data were obtained from TriNetX, a global healthcare research network. Adult postmenopausal women were enrolled if they were diagnosed with burn injury within 10 years after menopause onset. Patients with pre-existing abnormal uterine bleeding, gynecologic cancer, and chronic liver or heart disease were excluded. The population was grouped into those who received and those who did not receive estrogen treatment (ET) for evaluation of subsequent complications. Cohort balancing was performed using the exact match approach of Inverse Probability Treatment Weighting (IPTW). The average treatment effects (ATEs) and confidence intervals were computed for these balanced cohorts. Results: Postmenopausal women with ET had a lower risk of endometrial hyperplasia and malignancy 3 months (ATE = −0.005, −0.006) and 3 years (−0.007, −0.008) after mild burn injury (less than 20% of total body surface area) (p < 0.05), regardless of age. At the 3-month timepoint, postmenopausal women aged 45–65 with ET exhibited preventive effects against acute kidney injury (−0.0332), cerebral infarction (−0.0279), breast cancer (−0.0278) and severe sepsis (−0.011) after mild burn injury (p < 0.05) compared to women who did not receive ET. After 3 years, 45–65-year-old women with ET exhibited decreased rates of breast cancer (−0.0479) and endometrial hyperplasia (−0.0116) (p < 0.05) compared to those without ET. Conclusions: Estrogen treatment decreases the risk probabilities of breast cancer and other complications in postmenopausal women from 3 months to 3 years after mild burn injury. Full article

Palbociclib, a dual CDK4/6 kinase inhibitor used for breast cancer, has been explored as a treatment option for rheumatoid arthritis (RA). Preclinical studies have reported palbociclib-induced myelosuppression, but no such effects have been observed in Cdk4 or Cdk6 single-deficient mice. Synoviocyte proliferation-associated in collagen-induced arthritis 1/serum amyloid A-like 1 (SPACIA1/SAAL1) is involved in G1 phase progression. Given that SPACIA1/SAAL1 upregulates CDK6 (but not CDK4) expression, we aimed to determine whether suppressing CDK6 expression alone could prevent synovial hyperplasia without myelosuppression. The effects of CDK6 expression on TNF-α-induced rheumatoid arthritis synovial fibroblast (RASF) proliferation and synovial hyperplasia in collagen-induced arthritis (CIA) mice were investigated by modulating the transcriptional level with a CDK6 expression inhibitor (indole-3-carbinol), CDK6 small interfering RNA (siRNA), and Cdk6-deficient mice. Indole-3-carbinol or CDK6 siRNA inhibited TNF-α-induced RASF proliferation without suppressing CDK4 expression and reduced retinoblastoma protein phosphorylation. In CIA mice, indole-3-carbinol did not cause myelosuppression, considerably delayed CIA onset and progression, and reduced arthritis severity. Cdk6-deficient mice showed similar improvements in CIA pathogenesis but had lower serum anti-type II collagen IgG levels. Notably, synovial hyperplasia was not observed in Cdk6-deficient mice. CIA-synovial hyperplasia depends on CDK6, but not CDK4, expression. Full article

Endometrial cancer (EC) is the sixth most common cancer in women worldwide, with rising incidence, particularly in economically developed countries where obesity and type 2 diabetes are prevalent risk factors. EC comprises various histological subtypes with distinct behaviors: Type I tumors are generally estrogen-driven with favorable prognosis, while Type II tumors are hormone-independent, aggressive, and associated with poorer outcomes. Dysregulation of the cell cycle, particularly through cyclin-dependent kinases (CDKs) and their regulators like Cyclin D1 (CCND1), plays a crucial role in EC progression and recurrence. Cyclin D1 overexpression is often observed in the early stages of endometrioid carcinoma and complex hyperplasia, marking potential early carcinogenic events, while lower expression levels are common in high-grade subtypes like serous carcinoma. Although CDK inhibitors targeting Cyclin D1/CDK4/6 complexes have shown therapeutic potential in cancers such as breast and lung, their role in EC remains underexplored. This study integrates immunohistochemical evaluations of Cyclin D1 expression in EC patient samples with data from The Cancer Genome Atlas (TCGA) to assess its prognostic significance across EC subtypes. By correlating molecular, histopathological, and clinical outcomes, we aim to clarify the impact of Cyclin D1 dysregulation on EC progression and recurrence. Our findings may inform more personalized therapeutic approaches, particularly for high-grade and treatment-resistant forms of EC. Full article

B3 breast lesions, classified as lesions of uncertain malignant potential, present a significant diagnostic and therapeutic challenge due to their heterogeneous nature and variable risk of progression to malignancy. These lesions, which include atypical ductal hyperplasia (ADH), papillary lesions (PLs), flat epithelial atypia (FEA), radial scars (RSs), lobular neoplasia (LN), and phyllodes tumors (PTs), occupy a “grey zone” between benign and malignant pathologies, making their management complex and often controversial. This article explores the diagnostic difficulties associated with B3 lesions, focusing on the limitations of current imaging techniques, including mammography, ultrasound, and magnetic resonance imaging (MRI), as well as the challenges in histopathological interpretation. Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are widely used for diagnosis, but both methods have inherent limitations, including sampling errors and the inability to determine malignancy in some cases definitively. The therapeutic approach to B3 lesions is nuanced, with treatment decisions strongly influenced by factors such as the lesion size, radiological findings, histopathological characteristics, and patient factors. While some lesions can be safely monitored with watchful waiting, others may require vacuum-assisted excision (VAE) or surgical excision to rule out malignancy. The decision-making process is further complicated by the discordance between the BI-RADS score and biopsy results, as well as the presence of additional risk factors, such as microcalcifications. This review provides an in-depth analysis of the current diagnostic challenges and treatment strategies for B3 lesions, emphasizing the importance of a multidisciplinary approach to management. By synthesizing the most recent research, this article aims to provide clinicians with a clearer understanding of the complexities involved in diagnosing and treating B3 breast lesions while highlighting areas for future research, such as artificial intelligence and genomics, to improve the diagnostic accuracy and patient outcomes. Full article

Pubertal gynecomastia (PG) is a common condition characterized by the abnormal development and hyperplasia of unilateral or bilateral breast tissue in adolescent males, affecting up to 50% of appropriately aged adolescents and exhibiting rising prevalence over recent years. The etiology of PG is multifaceted, encompassing physiological, pharmacological, and pathological factors. This narrative review synthesizes evidence from a comprehensive selection of peer-reviewed literature, including observational studies, clinical trials, systematic reviews, and case reports, to explore the pivotal role of endocrine hormones in the pathogenesis of PG. Specifically, it examines the effects of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2), progesterone (P), prolactin (PRL), growth hormone (GH), insulin-like growth factor-1 (IGF-1), thyroid hormones (T3, T4), parathyroid hormone (PTH), anti-Müllerian hormone (AMH), human chorionic gonadotropin (hCG), and leptin. By synthesizing current insights, this review underscores the intricate hormonal dynamics underlying PG and their implications for diagnosis and treatment. Conclusively, the findings advocate for a personalized approach in the clinical management of PG, with particular emphasis on the hormonal milieu as a cornerstone of therapeutic strategy. Full article

Background/Objectives: B3 breast lesions, characterized by uncertain malignant potential, pose a significant challenge for clinicians. With the increasing use of preoperative biopsies, there is a need for careful management strategies, including watchful waiting, vacuum-assisted excision (VAE), and surgery. This study aims to assess the concordance between preoperative biopsy findings and postoperative histology, with a focus on evaluating the positive predictive value (PPV) for malignancy in B3 lesions. Methods: Over a seven-year period, 305 patients preoperatively diagnosed with B3 lesions were treated at the Multidisciplinary Breast Center of “Fondazione Policlinico Universitario Agostino Gemelli IRCCS” in Rome. All cases were reviewed at multidisciplinary meetings involving surgeons, radiologists, histopathologists, and oncologists. Preoperative diagnoses were obtained by ultrasound-guided core needle biopsies (CNBs) or stereotactic-guided vacuum-assisted biopsies (VABs). The radiological features were assessed using the Breast Imaging Reporting and Data System (BIRADS), and discrepancies between radiological and pathological findings were recorded. The biopsy results were compared with the postoperative histological findings to calculate the PPV for malignancy. Results: Of the 305 B3 lesions biopsied, 242 were confirmed as B3 on the final histological examination, resulting in a concordance rate of 79.3%. A total of 63 cases were upgraded to malignancy on postoperative histology, yielding a cumulative upgrade rate of 20.7%. The PPV for malignancy was 31.5% for atypical ductal hyperplasia (ADH), 27.6% for lobular neoplasia (LN), 22.9% for papillary lesions (PLs), 12.1% for flat epithelial atypia (FEA), 10.4% for radial scar (RS), and 10.3% for phyllodes tumors (PTs). Conclusions: Our findings demonstrate that the cumulative PPV for B3 lesions, as well as the PPV for each subtype, are consistent with the existing literature. The factors influencing the PPV include the use of CNB versus VAB, discordance between the BIRADS and biopsy results, the presence of atypia in the biopsy sample, the presence of microcalcifications on mammography, mass lesions identified on MRI, and the extent of the lesion. These factors should be considered in the personalized management of B3 lesions, potentially leading to more targeted and less invasive approaches in the future. Full article