Supplemental ultrasound screening in patients with a history of lobular neoplasia

Abstract

To investigate the role of ultrasound (US) screening as an adjunct to annual mammography (M) in breast cancer detection in women with a history of lobular neoplasia (LN) diagnosed following core needle or excisional biopsy. A retrospective review of our database was performed between 11/2006 and 11/2011 to identify patients diagnosed with LN, and underwent annual screening. Patients with a lifetime risk >20% per risk modeling were excluded. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and cancer detection rate (CDR) of each screening test were identified. Cancer type and detection modality were recorded. A total of 100 patients who had M and/or US screening were included. Mean patient age was 54.7 years (range 33‐83). All 100 patients underwent a mean of 3.9 rounds of screening M and 93 (93%) received US screening (mean 3.3 rounds). Of 93 patients who received both M and US screening, 12 (13%) were diagnosed with breast cancer. Mammographic CDR was 4%. Incremental US CDR was 6.5%. The sensitivity, specificity, and NPV for M screening alone was 33% (10%, 65%), 77% (67%, 85%), and 89% (80%, 95%), respectively. US and mammography screening had a combined sensitivity: 83% (52%, 98%), Specificity: 72% (62%, 81%), NPV: 97% (89%, 100%). Supplemental US screening resulted in a significant increase in sensitivity, yielding 6.5% incremental CDR in this high‐risk patient subgroup that does not fulfill ACS high‐risk MRI screening criteria.

Comparison of medical image interpretation time between conventional and automated methods of breast ultrasound

“…For the conventional method, they had extensive experience, probably interfering with our average time for this method, which was 10.77 minutes. This value is considerably lower than the average observed in the literature, (5,16,17) but similar to that of the study by Tutar et al (2020). (18) In this cross-sectional study with 340 patients undergoing screening, an average of 12.5 minutes was obtained by physicians breast radiologists.…”

Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer

“…It has been suggested by some as an additional imaging technique in women with dense breasts and in women with a higher risk of developing ILC. 77,78 Magnetic resonance imaging (MRI) is the modality with the highest sensitivity for ILC, being 93%-100%. 79 High sensitivity comes at the cost of a low specificity and overestimation of the size of the lesions in 20% of the patients (mainly because of the presence of lobular carcinoma in situ).…”

The Automation of Breast Ultrasonography and the Medical Time Dedicated to the Method

“…Considering the guiding question of this review, the medical time dedicated to the two methods of breast evaluation by ultrasound, we observed with the data from the studies included in this review that less medical time was spent on the automated method in most studies, but with few studies directly comparing both methods regarding the specific question of medical time dedicated to each one of them. 1 2 10 11 13 17 19 21 23…”

“…Considering the guiding question of this review, the medical time dedicated to the two methods of breast evaluation by ultrasound, we observed with the data from the studies included in this review that less medical time was spent on the automated method in most studies, but with few studies directly comparing both methods regarding the specific question of medical time dedicated to each one of them. 1,2,10,11,13,17,19,21,23 Of the nine selected studies, seven brought only time information for one of the methods, either because the measurement of this time had not been included in the methodology of these studies or because the comparison between the two methods was not the objective of these researches. 1,10,13,17,19,21,23 The two studies that presented the time for both methods differed in their conclusions regarding medical time.…”

“…In its traditional form, breast ultrasound requires a medical time that is usually considered long. 1 2 3…”