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Second-look ultrasonography for MRI-detected suspicious breast lesions in patients with breast cancer.

Hong MJ, Cha JH, Kim HH, Shin HJ, Chae EY, Shin JE, Choi WJ - Ultrasonography (2014)

Bottom Line: Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery.Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US.Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The purpose of this study is to evaluate the use of second-look ultrasonography (US) for investigating additional suspicious lesions detected on preoperative staging magnetic resonance imaging (MRI) for breast cancer.

Methods: Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery. Second-look US was recommended for 135 patients with 149 suspicious lesions, following the MRI interpretation, and 108 patients with 121 lesions were included in this study. The detection rate on second-look US, according to the lesion type, diameter, and histopathological outcome, was analyzed.

Results: Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US. Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign. Although a greater number of large malignant lesions were correlated on second-look US than small benign lesions, there was no statistically significant difference according to lesion diameter or type, as seen on MRI or pathology.

Conclusion: We have concluded that second-look US is a useful diagnostic tool for lesions incidentally detected on breast MRI, as in this study, it could identify 86.8% of the MRI-detected breast lesions.

No MeSH data available.


Related in: MedlinePlus

A 57-year-old woman with cancer in her left breast.A. A dynamic contrast-enhanced and subtracted T1-weighted axial image shows a small enhancing mass in her right breast. There were no correlated lesions seen on second-look ultrasonography (US). B. On follow-up magnetic resonance imaging performed 30 months later, a 1.5-cm irregular, enhancing mass (arrow) is detected at the same location in her right breast. C. US shows an oval hypoechoic mass (arrow) with an indistinct margin and confirmed it as invasiveductal carcinoma.
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f3-usg-14046: A 57-year-old woman with cancer in her left breast.A. A dynamic contrast-enhanced and subtracted T1-weighted axial image shows a small enhancing mass in her right breast. There were no correlated lesions seen on second-look ultrasonography (US). B. On follow-up magnetic resonance imaging performed 30 months later, a 1.5-cm irregular, enhancing mass (arrow) is detected at the same location in her right breast. C. US shows an oval hypoechoic mass (arrow) with an indistinct margin and confirmed it as invasiveductal carcinoma.

Mentions: All 105 correlated lesions were pathologically confirmed by means of US-guided CNB (n=38) or by US-guided localization and excisional biopsy (n=67); 29 (27.6%) were proven to be malignant, and 76 (72.4%) were benign. The pathologic types of the malignant lesions included 17 invasive ductal carcinomas (Fig. 1) and 12 DCISs, and the benign lesions were fibroadenomas (Fig. 2), nonproliferative breast changes, adenosis, atypical ductal hyperplasia, usual ductal hyperplasia, dense fibrosis, columnar cell hyperplasia, fibrocystic changes, intraductal papilloma, and proliferative breast lesions. Of the 16 uncorrelated lesions seen on second-look US, two were proven to be invasive ductal cancers after a 30-month followup examination, and the patients with these two lesions underwent breast-conserving surgery (Fig. 3). The remaining 14 lesions were considered benign on the basis of a 2-year follow-up and the patients’ clinical records. Although malignancy tended to be more correlated than benignancy, there was no statistically significant difference between the correlated and the non-correlated groups on the basis of the histopathology outcome as follows: benign versus malignant (P=0.197) and invasive versus in-situ carcinoma (P=0.510).


Second-look ultrasonography for MRI-detected suspicious breast lesions in patients with breast cancer.

Hong MJ, Cha JH, Kim HH, Shin HJ, Chae EY, Shin JE, Choi WJ - Ultrasonography (2014)

A 57-year-old woman with cancer in her left breast.A. A dynamic contrast-enhanced and subtracted T1-weighted axial image shows a small enhancing mass in her right breast. There were no correlated lesions seen on second-look ultrasonography (US). B. On follow-up magnetic resonance imaging performed 30 months later, a 1.5-cm irregular, enhancing mass (arrow) is detected at the same location in her right breast. C. US shows an oval hypoechoic mass (arrow) with an indistinct margin and confirmed it as invasiveductal carcinoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4372709&req=5

f3-usg-14046: A 57-year-old woman with cancer in her left breast.A. A dynamic contrast-enhanced and subtracted T1-weighted axial image shows a small enhancing mass in her right breast. There were no correlated lesions seen on second-look ultrasonography (US). B. On follow-up magnetic resonance imaging performed 30 months later, a 1.5-cm irregular, enhancing mass (arrow) is detected at the same location in her right breast. C. US shows an oval hypoechoic mass (arrow) with an indistinct margin and confirmed it as invasiveductal carcinoma.
Mentions: All 105 correlated lesions were pathologically confirmed by means of US-guided CNB (n=38) or by US-guided localization and excisional biopsy (n=67); 29 (27.6%) were proven to be malignant, and 76 (72.4%) were benign. The pathologic types of the malignant lesions included 17 invasive ductal carcinomas (Fig. 1) and 12 DCISs, and the benign lesions were fibroadenomas (Fig. 2), nonproliferative breast changes, adenosis, atypical ductal hyperplasia, usual ductal hyperplasia, dense fibrosis, columnar cell hyperplasia, fibrocystic changes, intraductal papilloma, and proliferative breast lesions. Of the 16 uncorrelated lesions seen on second-look US, two were proven to be invasive ductal cancers after a 30-month followup examination, and the patients with these two lesions underwent breast-conserving surgery (Fig. 3). The remaining 14 lesions were considered benign on the basis of a 2-year follow-up and the patients’ clinical records. Although malignancy tended to be more correlated than benignancy, there was no statistically significant difference between the correlated and the non-correlated groups on the basis of the histopathology outcome as follows: benign versus malignant (P=0.197) and invasive versus in-situ carcinoma (P=0.510).

Bottom Line: Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery.Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US.Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The purpose of this study is to evaluate the use of second-look ultrasonography (US) for investigating additional suspicious lesions detected on preoperative staging magnetic resonance imaging (MRI) for breast cancer.

Methods: Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery. Second-look US was recommended for 135 patients with 149 suspicious lesions, following the MRI interpretation, and 108 patients with 121 lesions were included in this study. The detection rate on second-look US, according to the lesion type, diameter, and histopathological outcome, was analyzed.

Results: Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US. Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign. Although a greater number of large malignant lesions were correlated on second-look US than small benign lesions, there was no statistically significant difference according to lesion diameter or type, as seen on MRI or pathology.

Conclusion: We have concluded that second-look US is a useful diagnostic tool for lesions incidentally detected on breast MRI, as in this study, it could identify 86.8% of the MRI-detected breast lesions.

No MeSH data available.


Related in: MedlinePlus