Can second-look ultrasound downgrade MRI-detected lesions? A retrospective study Journal Article


Authors: Kolta, M.; Clauser, P.; Kapetas, P.; Bernathova, M.; Pinker, K.; Helbich, T. H.; Baltzer, P. A. T.
Article Title: Can second-look ultrasound downgrade MRI-detected lesions? A retrospective study
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. © 2020 Elsevier B.V.
Keywords: magnetic resonance imaging; breast cancer; bi-rads; image- guided biopsy; second-look ultrasound
Journal Title: European Journal of Radiology
Volume: 127
ISSN: 0720-048X
Publisher: Elsevier B.V  
Date Published: 2020-06-01
Start Page: 108976
Language: English
DOI: 10.1016/j.ejrad.2020.108976
PROVIDER: scopus
PUBMED: 32339982
PMCID: PMC8223588
DOI/URL:
Notes: Article -- Source: Scopus
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