OBJECTIVES: To evaluate second-look digital breast tomosynthesis (SL-DBT) for additional findings (AFs) at preoperative MRI compared with second-look ultrasound (SL-US). METHODS: We included 135 patients with breast cancer who underwent digital mammography (DM), DBT, US, and MRI at two centres. MR images were retrospectively evaluated to find AFs, described as focus, mass, or non-mass; ≤10 mm or >10 mm in size; BI-RADS 3, 4, or 5. DM and DBT exams were reviewed looking for MRI AFs; data on SL-US were collected. Reference standard was histopathology or ≥12-month negative follow-up. Fisher exact test and McNemar test were used. RESULTS: Eighty-four AFs were detected in 53/135 patients (39%, 95%CI 31-48%). A correlate was found for 44/84 (52%, 95%CI 41-63%) at SL-US, for 20/84 (24%, 95%CI 11-28%) at SL-DM, for 42/84 (50%, 95%CI 39-61%) at SL-DBT, for 63/84 (75%, 95%CI 64-84%) at SL-DBT, and/or SL-US, the last rate being higher than for SL-US only, overall (p < 0.001), for mass or non-mass, ≤ or >10 mm, BI-RADS 4 or 5, or malignant lesions (p < 0.031). Of 21 AFs occult at both SLs, 17 were malignant (81%, 95%CI 58-94%). CONCLUSIONS: When adding SL-DBT to SL-US, AFs detection increased from 52% to 75%. MR-guided biopsy is needed for the remaining 25%. KEY POINTS: • Detection rate of MRI AFs using SL-US was 52% • Adding SL-DBT, the detection rate of MRI AFs significantly increased to 75%. • Over 80% of the remaining 25% MRI AFs were malignant. • MR-guided biopsy should be used when SL-US and SL-DBT are inconclusive.
OBJECTIVES: To evaluate second-look digital breast tomosynthesis (SL-DBT) for additional findings (AFs) at preoperative MRI compared with second-look ultrasound (SL-US). METHODS: We included 135 patients with breast cancer who underwent digital mammography (DM), DBT, US, and MRI at two centres. MR images were retrospectively evaluated to find AFs, described as focus, mass, or non-mass; ≤10 mm or >10 mm in size; BI-RADS 3, 4, or 5. DM and DBT exams were reviewed looking for MRI AFs; data on SL-US were collected. Reference standard was histopathology or ≥12-month negative follow-up. Fisher exact test and McNemar test were used. RESULTS: Eighty-four AFs were detected in 53/135 patients (39%, 95%CI 31-48%). A correlate was found for 44/84 (52%, 95%CI 41-63%) at SL-US, for 20/84 (24%, 95%CI 11-28%) at SL-DM, for 42/84 (50%, 95%CI 39-61%) at SL-DBT, for 63/84 (75%, 95%CI 64-84%) at SL-DBT, and/or SL-US, the last rate being higher than for SL-US only, overall (p < 0.001), for mass or non-mass, ≤ or >10 mm, BI-RADS 4 or 5, or malignant lesions (p < 0.031). Of 21 AFs occult at both SLs, 17 were malignant (81%, 95%CI 58-94%). CONCLUSIONS: When adding SL-DBT to SL-US, AFs detection increased from 52% to 75%. MR-guided biopsy is needed for the remaining 25%. KEY POINTS: • Detection rate of MRI AFs using SL-US was 52% • Adding SL-DBT, the detection rate of MRI AFs significantly increased to 75%. • Over 80% of the remaining 25% MRI AFs were malignant. • MR-guided biopsy should be used when SL-US and SL-DBT are inconclusive.
Authors: Francesco Sardanelli; Gian M Giuseppetti; Pietro Panizza; Massimo Bazzocchi; Alfonso Fausto; Giovanni Simonetti; Vincenzo Lattanzio; Alessandro Del Maschio Journal: AJR Am J Roentgenol Date: 2004-10 Impact factor: 3.959
Authors: Nicky H G M Peters; Inne H M Borel Rinkes; Nicolaas P A Zuithoff; Willem P T M Mali; Karel G M Moons; Petra H M Peeters Journal: Radiology Date: 2007-11-16 Impact factor: 11.105
Authors: Samantha A Langer; Kathleen C Horst; Debra M Ikeda; Bruce L Daniel; Christina S Kong; Frederick M Dirbas Journal: Am J Surg Date: 2005-10 Impact factor: 2.565
Authors: M L Luciani; F Pediconi; M Telesca; F Vasselli; V Casali; E Miglio; R Passariello; C Catalano Journal: Radiol Med Date: 2011-02-01 Impact factor: 3.469
Authors: Andrea Teifke; Hans Anton Lehr; Toni Werner Vomweg; Alexander Hlawatsch; Manfred Thelen Journal: AJR Am J Roentgenol Date: 2003-09 Impact factor: 3.959
Authors: Constance D Lehman; Constantine Gatsonis; Christiane K Kuhl; R Edward Hendrick; Etta D Pisano; Lucy Hanna; Sue Peacock; Stanley F Smazal; Daniel D Maki; Thomas B Julian; Elizabeth R DePeri; David A Bluemke; Mitchell D Schnall Journal: N Engl J Med Date: 2007-03-28 Impact factor: 91.245