Study: MRI breast lesions worth a second look on ultrasound
Second-look sonography has value in the evaluation of abnormalities found on breast MRI, according to a retrospective review in this month’s issue of the Journal of Ultrasound in Medicine.
Stamatia Destounis, MD, and colleagues at Elizabeth Wende Breast Care in Rochester, N.Y., assessed the utility and efficacy of second-look breast sonography in the evaluation of abnormalities identified on presurgical breast MRI exams.
The researchers performed a review of 152 presurgical breast MRI exams having 196 unsuspected abnormalities to identify findings that underwent subsequent breast sonography. They identified eligible exams as those that had a suspicious abnormality on presurgical MRI, the documentation of the location and size of the finding on MRI and subsequent second-look sonography.
The authors also noted that 14 exams not meeting the criteria were excluded, with 182 abnormalities remaining.
Destounis and colleagues reported that 70 percent of breast MRI lesions were visible at second-look sonography; 30 percent were sonographically occult. Ninety-five percent of sonographically visible abnormalities underwent breast biopsy.
The pathologic exams of sampled sonographically visible lesions revealed 39 cancers, nine high-risk lesions, 72 benign lesions and one lesion not specified at surgery, according to the authors, who noted that 23 percent of cancers were in the contralateral breast. Fifty-four lesions were sonographically occult.
The investigators said that needle biopsy was performed for 93 percent of occult lesions, revealing eight cancers, one high-risk lesion, and 41 benign lesions; three of the benign lesions did not have sufficient pathologic specimens but were benign at follow-up.
MRI guidance was used in 86 percent of these biopsies.
They identified one contralateral cancer in the sonographically occult subset. Of the 182 lesions that underwent second-look sonography, 20 percent had a change in management.
Stamatia Destounis, MD, and colleagues at Elizabeth Wende Breast Care in Rochester, N.Y., assessed the utility and efficacy of second-look breast sonography in the evaluation of abnormalities identified on presurgical breast MRI exams.
The researchers performed a review of 152 presurgical breast MRI exams having 196 unsuspected abnormalities to identify findings that underwent subsequent breast sonography. They identified eligible exams as those that had a suspicious abnormality on presurgical MRI, the documentation of the location and size of the finding on MRI and subsequent second-look sonography.
The authors also noted that 14 exams not meeting the criteria were excluded, with 182 abnormalities remaining.
Destounis and colleagues reported that 70 percent of breast MRI lesions were visible at second-look sonography; 30 percent were sonographically occult. Ninety-five percent of sonographically visible abnormalities underwent breast biopsy.
The pathologic exams of sampled sonographically visible lesions revealed 39 cancers, nine high-risk lesions, 72 benign lesions and one lesion not specified at surgery, according to the authors, who noted that 23 percent of cancers were in the contralateral breast. Fifty-four lesions were sonographically occult.
The investigators said that needle biopsy was performed for 93 percent of occult lesions, revealing eight cancers, one high-risk lesion, and 41 benign lesions; three of the benign lesions did not have sufficient pathologic specimens but were benign at follow-up.
MRI guidance was used in 86 percent of these biopsies.
They identified one contralateral cancer in the sonographically occult subset. Of the 182 lesions that underwent second-look sonography, 20 percent had a change in management.