Breast ultrasound diagnostic performance and outcomes for mass lesions using Breast Imaging Reporting and Data System category 0 mammogram

Abstract

PURPOSE:To evaluate the outcomes and diagnostic performance of ultrasonography after a Breast Imaging Reporting and Data System (Bi-RADS) category 0 mammogram.MATERIAL AND METHODS:This retrospective study reviewed 4,384 consecutive patients who underwent a screening mammography from January 2005 to July 2006; 391 of the 4,384 exams were classified as Bi-RADS category 0. After exclusions, 241 patients received subsequent sonogram. Ultrasonography was considered diagnostic when the Bi-RADS category was changed to 2, 4, or 5, and it was considered indeterminate (Bi-RADS 3) when the results indicated that the patients should return for a mammographic follow-up. The outcomes of these patients were assessed to evaluate the diagnostic performance of ultrasonography.RESULTS:The mean age of the patients was 53.3 years (ranging from 35 to 81). Of the 241 patients, ultrasonography was considered diagnostic in 146 (60.6%) patients and indeterminate in 95 (39.4%) patients. In the diagnostic group, 111 out of 146 patients (70.2%) had a sonogram result of Bi-RADS category 2 after a 2-year follow-up without evidence of malignancy. Furthermore, 35 out of 146 patients (29.8%) had a suspicious sonogram with a result of Bi-RADS category 4. After a tissue sampling procedure, 10 patients were confirmed to have breast cancer, and 25 had benign histopathological features without any evidence of malignancy after a 2-year follow-up. The sensitivity of ultrasonography was 100%, specificity was 89.1%, and overall accuracy was 89.6%.CONCLUSIONS:Based on the degree of resolution and its diagnostic performance, ultrasonography was determined to be an excellent method for the subsequent evaluation of Bi-RADS 0 mammograms.

Limitations of mammography in the diagnosis of breast diseases compared with ultrasonography: a single-center retrospective analysis of 274 cases

“…In the present study, all patients were from the Anhui Province, which is an undeveloped province in the middle of China, and most of these patients had dense breast tissue and small breast volume. Of the 274 cases, 38 (13.9%) were classified as BI-RADS category 0, meaning that an important proportion of women undergoing MG could not be satisfactorily assessed, which is supported by previous studies [ 19 , 20 ]. In addition, 30 (10.9%) patients assessed as being BI-RADS category 1 by MG had a palpable mass by clinical examination or had an obvious mass by US, prompting surgery.…”

“…Stratified analysis showed that young age, premenopausal, and high breast density decreased the diagnostic accuracy of MG. Indeed, dense breast tissues interfere with the interpretation of MG [ 5 , 20 - 23 ].…”

Breast Ultrasonographic and Histopathological Characteristics Without Any Mammographic Abnormalities

“…We previously examined the correlation between US findings and the corresponding histopathological features in breast disorders in our previous study (6). There have been relatively few reported studies on assessing US performance and its resolution without any mammographic abnormalities (8). Therefore, in this study, we evaluated US findings and the corresponding histopathological characteristics for breast cancer patients with Breast Imaging Reporting and Data System (BI-RADS) (9) category 1 mammogram.…”

Are Both Ultrasonography and Mammography Necessary for Cancer Investigation of Breast Lumps in Resource-Limited Countries?

“…Microcalcification was detected in 74% of patients with ductal carcinoma in situ of the breast (54 in 73 patients) [28]. Ultrasonography also detected abnormality when mammography reported Bi-RADS = 0 [29]. Subgroup analysis also showed that patients with Bi-RADS below 4 might gain more benefit from additional ultrasound investigation, while for those with Bi-RADS 4 and above who already had high possibility for cancer, ultrasound might not gain any additional information.…”