Under the Freedom of Information Act, please could you provide the following information for your Trust?
1. How many benign breast lesions has your Trust diagnosed per annum in the last three years?
2. How many benign breast lesions have been removed surgically per annum within your Trust in the last three years?
a. Of this total number, how many of these are classified as B2?
b. Of this total number, how many of these are classified as B3?
3. How many benign breast lesions have not been removed per annum in the last three years?
4. How many benign breast lesions have been removed by vacuum assisted excision (VEA) per annum in the last three years?
a. Of this total number, how many of these are classified as B2 (definition below)?
b. Of this total number, how many of these are classified as B3 (definition below)?
5. Is the Trust aware of NICE guidance promoting the use of VAE for removal of benign lesions?
6. Does the Trust have a referral pathway in place for vacuum assisted percutaneous excision of benign breast lesions?

With regards to this request, please note the following:

B3 Breast Lesion – Lesion of Uncertain Malignant Potential
Findings typical of this category include:
1. Clusters of tiny calcifications – round or oval
2. Non-calcified solid nodules (no size limitation but non palpable on physical examination), round, ovoid and well-defined.
3. Selected focal asymmetrical areas of fibroglandular densities (not palpable): This might include concave-outward defined margins, interspersed with fat and without central increased fibular density on two projections.
4. Miscellaneous focal findings, such as a dilated duct or post biopsy architectural distortion without central density
5. Generalized distribution in both breasts. For example, multiple similar lesions with tiny calcifications or nodules distributed randomly

B2 Breast Lesion – Benign Lesion
A definitive benign finding indicating something abnormal on a mammogram but not something that is breast cancer or malignant in any way. Findings often include:
1. Round opacities with macrocalcifications (typical calcified fibroadenoma or cyst)
2. Round opacities corresponding to a typical cyst at ultrasonography
3. Oval opacities with a radiolucent center
4. Fatty densities or partially fatty images (lipoma, galactocele, oil cyst, hamartoma )
5. Surgical scar
6. Scattered macrocalcifications (fibroadenoma, cyst, cytosteatonecrosis, secretory ductal ectasia);
7. Vascular calcifications
8. Breast implants, silicone granuloma

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