The value of second-look ultrasonography for magnetic resonance imaging-detected suspicious breast lesions in patients with breast cancer
The value of second-look ultrasonography for breast cancer
Keywords:Breast cancer, magnetic resonance imaging, ultrasonography
Objective: Breast magnetic resonance imaging (b-MRI) is a highly sensitive diagnostic tool for detecting breast cancer (BC), but its relatively low specificity often requires tissue sampling. This study aimed to assess the utility and efficacy of second-look ultrasound (SLUS) in evaluating incidentally enhancing lesions (IELs) identified by preoperative contrast-enhanced breast MRI (CE-bMRI) and to review our institutional experience.
Methods: The study enrolled histopathologically proven invasive BC patients, who underwent preoperative CE-bMRI for cancer staging and were scanned with SLUS for IELs detected on MRI. The lesions’ imaging features and morphological analyses were assessed using the Breast Imaging and Reporting and Data System (BI-RADS). According to the BI-RADS classification, IELs considered Category 3 or 4 and had a suspicious correlate on SLUS were biopsied immediately.
Results: Additional IELs were detected in 121 of 352 (34.37%) patients on preoperative CE-bMRI, which was performed for staging. One hundred thirteen lesions were SLUS-correlated. BI-RADS Category 2 and 3 lesions were managed conservatively, while Category 4 lesions were biopsied under imaging guidance. The majority of the IELs were ipsilateral with known BC (61.00%), unifocal (62.26%), and showed mass enhancement, classified as BI-RADS 4 (57.23%) with indistinct and spiculated margins (71.68%). SLUS yielded a detection rate of 68.59%.
Conclusion: SLUS may be a valuable tool in evaluating lesions initially detected in breast MRI and can help reduce unnecessary biopsies.
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