Biopsy of Occult Breast Lesions

Meyer, Jack E.; Eberlein, Timothy J.; Stomper, Paul C.; Sonnenfeld, M R

doi:10.1001/jama.1990.03440170063037

Cited by 89 publications

(6 citation statements)

References 16 publications

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“…In practice, the decision on the work-up of BI-RADS 3 lesions depends on the possibilities for biopsy procedures, the wishes of the patient and the preference of the radiologist. Most patients who are referred for a biopsy have benign disease because of the low predictive value of both physical examination and mammography [ 5 , 6 ] . The value of breast MRI in BI-RADS 3 lesions is not yet clear [ 4 ] .…”

Section: Introductionmentioning

confidence: 99%

Breast magnetic resonance imaging as a problem-solving modality in mammographic BI-RADS 3 lesions

Dorrius

Pijnappel²,

Weide³

et al. 2010

Cancer Imaging

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The probability of a mammographic Breast Imaging Reporting and Data System (BI-RADS) 3 lesion being cancer is considered to be less than 2%. Therefore, the work-up of a mammographic BI-RADS 3 lesion should be biopsy or follow-up mammography after 6 months. However, most patients referred for biopsy have benign disease. Although the negative predictive value (NPV) of magnetic resonance imaging (MRI) is highest of all imaging techniques, it is not yet common practice to use breast MRI as a problem-solving modality to exclude patients for further diagnostic work-up. Therefore, in this meta-analysis the usefulness of breast MRI as a problem-solving modality in mammographic BI-RADS 3 lesions is investigated. After a systematic search only 5 out of 61 studies met the inclusion criteria. The NPV in 2 of those studies was reported to be 100%. It was concluded that MRI can be used as an adjunctive tool to mammographic BI-RADS 3 findings to exclude patients for further diagnostic work-up. The other 3 studies assessed the accuracy of MRI in mammographic BI-RADS 3 microcalcifications. These studies reported an NPV of MRI between 76% and 97%. Therefore, MRI cannot be implemented as a diagnostic tool to evaluate mammographic microcalcifications at this time. The first solid data indicate that breast MRI might be useful as a problem-solving modality to exclude patients with non-calcified mammographic BI-RADS 3 lesions for further diagnostic work-up. However, further research is needed to verify these results.

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Section: Introductionmentioning

confidence: 99%

Breast magnetic resonance imaging as a problem-solving modality in mammographic BI-RADS 3 lesions

Dorrius

Pijnappel²,

Weide³

et al. 2010

Cancer Imaging

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“…Biopsy was the best way to confirm whether a tumor would be benign or malignant, however, it was invasive, carried the risk of infection, and expensive, and only 10% -31% of biopsied tumors were malignant (4,5). To avoid unnecessary biopsy, assuage anxiety, and increased diagnostic confidence, computer-aided diagnosis (CAD) systems have been developed.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Breast Tumors with Sonographic Texture Analysis Using Run-length Matrix

et al. 2017

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Background: Early detection and reliable diagnosis of breast cancer could lead to improved cure rates and reduce mortality and management costs. Objectives: To explore the potential of texture analysis based on run-length matrix features for classifying benign and malignant breast tumors in ultrasound imaging. Methods: A total of 70 breast tumors (38 benign and 32 malignant) have used in the proposed computer-aided diagnosis system. Twenty run-length matrix features have extracted for texture analysis in three normalizations (default, 3sigma, and 1% -99%). Linear discriminant analysis and principal component analysis have employed to transform raw data to lower-dimensional spaces and increase discriminative power. The features have classified by the first nearest neighbor classifier. Results:The features under 3sigma normalization have designed via Linear discriminant analysis indicated high performance in classifying benign and malignant breast tumors with a sensitivity of 96.87%, specificity of 100%, accuracy of 98.57%, positive predictive value of 100%, and negative predictive value of 97.43%. The area under receiver operating characteristic curve was 0.992. Conclusions: Run-length matrix features had a high potential to characterize and could help radiologist to diagnosis breast tumors.

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“…Based on imaging characteristics, microcalcifications often cannot be classified as benign or malignant; in these cases, pathological examination by biopsy is recommended [3456]. …”

Section: Introductionmentioning

confidence: 99%

Detectability and Usefulness of Automated Whole Breast Ultrasound in Patients with Suspicious Microcalcifications on Mammography: Comparison with Handheld Breast Ultrasound

et al. 2016

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PurposeThe purpose of this study was to prospectively evaluate the detectability and usefulness of automated whole breast ultrasound (AWUS) and to compare it with handheld breast ultrasound (HHUS) in cases with suspicious microcalcifications identified by mammography.MethodsForty-two patients with 43 suspicious microcalcifications (25 malignant and 18 benign) detected by mammography underwent AWUS, HHUS, and histol-ogic examination. With knowledge of the mammographic findings, HHUS was performed to assess the visibility of the microcalcifications and the presence of associated masses or ductal changes. Two radiologists reviewed the AWUS images in consensus using the same methods employed for HHUS. Detectability of AWUS was compared with that of HHUS and was correlated with histologic and mammographic findings.ResultsOf the 43 lesions, 32 (74.4%) were detectable by AWUS and 31 (72.1%) by HHUS. No significant differences in sensitivity were found between the two methods (p=0.998). AWUS detected 96% (24/25) of malignant microcalcifications and 44.4% (8/18) of benign microcalcifications. AWUS was more successful in the detection of malignant vs. benign lesions (96.0% vs. 44.4%, p=0.002), lesions >10 mm vs. ≤10 mm in size (86.7% [26/30] vs. 46.2% [6/13], p=0.009), lesions with a fine pleomorphic or linear shape vs. a round or amorphous or coarse heterogeneous shape (94.7% [18/19] vs. 58.3% [14/24], p=0.021), and lesions associated with a mass or architectural distortion vs. without obvious changes on mammography (100% [19/19] vs. 54.2% [13/24], p=0.022).ConclusionDetectability of AWUS was comparable to that of HHUS in cases where suspicious microcalcifications were identified on mammography. Therefore, AWUS might be helpful in the performance of ultrasound-guided percutaneous procedures for highly suspicious microcalcifications.

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Biopsy of Occult Breast Lesions

Cited by 89 publications

References 16 publications

Breast magnetic resonance imaging as a problem-solving modality in mammographic BI-RADS 3 lesions

Breast magnetic resonance imaging as a problem-solving modality in mammographic BI-RADS 3 lesions

Diagnosis of Breast Tumors with Sonographic Texture Analysis Using Run-length Matrix

Detectability and Usefulness of Automated Whole Breast Ultrasound in Patients with Suspicious Microcalcifications on Mammography: Comparison with Handheld Breast Ultrasound

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