Michael Kolta1, Paola Clauser1, Panagiotis Kapetas1, Maria Bernathova1, Katja Pinker2, Thomas H Helbich1, Pascal A T Baltzer3. 1. Department of Biomedical Imaging and Image-Guided Therapy, General and Pediatric Radiology, Allgemeines Krankenhaus, Medical University of Vienna, Austria. 2. Department of Biomedical Imaging and Image-Guided Therapy, General and Pediatric Radiology, Allgemeines Krankenhaus, Medical University of Vienna, Austria; Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, USA. 3. Department of Biomedical Imaging and Image-Guided Therapy, General and Pediatric Radiology, Allgemeines Krankenhaus, Medical University of Vienna, Austria. Electronic address: pascal.baltzer@meduniwien.ac.at.
Abstract
PURPOSE: To determine whether MRI-detected suspicious (BIRADS 4 & 5) breast lesions can be downgraded using second-look ultrasound (SLU) and thus reduce unnecessarily performed breast biopsies. MATERIALS METHODS: A retrospective single-center review of consecutive patients, who underwent breast MRI studies during a 12-month time period was performed. 94 patients with 103 lesions undergoing SLU of incidentally detected MRI BI-RADS 4&5 lesions which were not identified on previous ultrasound were included in the study. The SLU detection rate and SLU features of the lesions were assessed. Histology (91/103) or two year follow up (n = 12) were defined as the reference standard for lesion diagnosis. RESULTS: 57 (55.3 %) of the 103 lesions were identified on SLU. 17 of the identified lesions were malignant (29.8 %). Lesions detected on ultrasound presented on MRI as masses in 66.7 % (38/57) and non-mass in 33.3 % (19/57). Our findings showed that it is possible to distinguish between malignant and benign lesions with SLU. The results were significant (p < 0.05) for the following morphological features: shape, orientation, margins, architectural distortion, hyperechoic rim/ edema. All lesions classified as SLU BI-RADS 2 in our study were benign and thus, 30 % of all unnecessary biopsies could potentially have been avoided. Including SLU BI-RADS 3 lesions, this rate increased to 60 %, while yielding one (of 17, 5.8 %) false negative result. All three BI-RADS 5 lesions detected by SLU presented as malignant on ultrasound. CONCLUSION: SLU can potentially downgrade incidental MRI BIRADS 4 lesions. This may reduce the number of unnecessarily performed biopsies by 30-60 %, thus simplifying patient management.
PURPOSE: To determine whether MRI-detected suspicious (BIRADS 4 & 5) breast lesions can be downgraded using second-look ultrasound (SLU) and thus reduce unnecessarily performed breast biopsies. MATERIALS METHODS: A retrospective single-center review of consecutive patients, who underwent breast MRI studies during a 12-month time period was performed. 94 patients with 103 lesions undergoing SLU of incidentally detected MRI BI-RADS 4&5 lesions which were not identified on previous ultrasound were included in the study. The SLU detection rate and SLU features of the lesions were assessed. Histology (91/103) or two year follow up (n = 12) were defined as the reference standard for lesion diagnosis. RESULTS: 57 (55.3 %) of the 103 lesions were identified on SLU. 17 of the identified lesions were malignant (29.8 %). Lesions detected on ultrasound presented on MRI as masses in 66.7 % (38/57) and non-mass in 33.3 % (19/57). Our findings showed that it is possible to distinguish between malignant and benign lesions with SLU. The results were significant (p < 0.05) for the following morphological features: shape, orientation, margins, architectural distortion, hyperechoic rim/ edema. All lesions classified as SLU BI-RADS 2 in our study were benign and thus, 30 % of all unnecessary biopsies could potentially have been avoided. Including SLU BI-RADS 3 lesions, this rate increased to 60 %, while yielding one (of 17, 5.8 %) false negative result. All three BI-RADS 5 lesions detected by SLU presented as malignant on ultrasound. CONCLUSION: SLU can potentially downgrade incidental MRI BIRADS 4 lesions. This may reduce the number of unnecessarily performed biopsies by 30-60 %, thus simplifying patient management.
Authors: Alexander Bumberger; Paola Clauser; Michael Kolta; Panagiotis Kapetas; Maria Bernathova; Thomas H Helbich; Katja Pinker; Pascal A Baltzer Journal: Eur J Radiol Date: 2019-02-11 Impact factor: 3.528
Authors: Ritse M Mann; Corinne Balleyguier; Pascal A Baltzer; Ulrich Bick; Catherine Colin; Eleanor Cornford; Andrew Evans; Eva Fallenberg; Gabor Forrai; Michael H Fuchsjäger; Fiona J Gilbert; Thomas H Helbich; Sylvia H Heywang-Köbrunner; Julia Camps-Herrero; Christiane K Kuhl; Laura Martincich; Federica Pediconi; Pietro Panizza; Luis J Pina; Ruud M Pijnappel; Katja Pinker-Domenig; Per Skaane; Francesco Sardanelli Journal: Eur Radiol Date: 2015-05-23 Impact factor: 5.315
Authors: Paola Clauser; Ritse Mann; Alexandra Athanasiou; Helmut Prosch; Katja Pinker; Matthias Dietzel; Thomas H Helbich; Michael Fuchsjäger; Julia Camps-Herrero; Francesco Sardanelli; Gabor Forrai; Pascal A T Baltzer Journal: Eur Radiol Date: 2017-11-22 Impact factor: 5.315
Authors: Karin Hellerhoff; Hanna Dietrich; Regina Schinner; Dorothea Rjosk-Dendorfer; Anikó Sztrókay-Gaul; Maximilian Reiser; Susanne Grandl Journal: Breast Care (Basel) Date: 2021-01-18 Impact factor: 2.268