Feature | August 26, 2013

Multicenter Trial Finds BI-RADS 3 Breast Lesions Have Low Cancer Rate

Multicenter Trial BI-RADS 3 Breast Lesions Low Cancer Rate

August 26, 2013 — Based on data from a multi-site imaging trial involving more than 2,600 women, researchers say breast lesions categorized as ‘probably benign’ on supplemental screening ultrasound could be re-evaluated with imaging in 12 months, reducing patient anxiety, follow-up exams and unnecessary biopsies. Results of the study are published online in the journal Radiology.

In the study, a team of researchers analyzed data from the American College of Radiology Imaging Network (ACRIN) trial 6666, in which both annual mammography and ultrasound screenings were performed on women with dense breasts at 21 sites around the country. Ultrasound is increasingly being used as a supplement to screening mammography because it is able to detect breast cancers that may not be visible with mammography, especially in dense breasts.

“Supplemental ultrasound screening increases cancer detection beyond mammography alone, but may also result in an increased number of additional tests,” said lead researcher Richard G. Barr, M.D., Ph.D., professor of radiology at the Northeast Ohio Medical University in Youngstown, Ohio. “Both screening ultrasound and screening mammography have similar issues: to find breast cancers, a large number of biopsies must be performed, most of which turn out to be negative.”

Barr and colleagues analyzed the trial’s ultrasound-detected lesions assessed as probably benign or category 3 of the Breast Imaging-Reporting and Data System (BI-RADS), a standardized system of assessing breast lesions and their probability of malignancy based on appearance, to determine the prevalence and malignancy rate of these lesions.

Guidelines suggest that BI-RADS 3 lesions should be monitored for suspicious changes with additional imaging at intervals of six, 12 and 24 months.

“BI-RADS 3 lesions are common on screening ultrasound and often lead to unnecessary biopsies and additional imaging, causing substantial cost and anxiety for patients,” Barr said. “We wanted to study these BI-RADS 3 lesions to look for ways to perform fewer biopsies without missing breast cancers.”

The researchers analyzed the screening ultrasound exams and follow-up data of 2,662 trial participants recruited between 2004 and 2006. Of the 2,662 women, 519 had a total of 745 BI-RADS 3 lesions, representing 25 percent of all ultrasound-detected lesions in the study.

Of the 745 BI-RADS 3 lesions, six were malignant for a total malignancy rate of 0.8 percent. The average size of the detected cancers among the BI-RADS 3 lesions was 10 millimeters.

During six-month follow-up imaging, suspicious changes were observed in only one of the 745 BI-RADS 3 lesions. At 12-month follow-up imaging, suspicious changes were observed in a second BI-RADS 3 lesion, revealing an invasive breast cancer that had not yet spread beyond the breast.

“As a result of the low malignancy rate of BI-RADS 3 lesions and the low rate of suspicious changes at six-month follow-up imaging, yearly follow-up for these lesions may be appropriate,” Barr said. “The cancers detected due to changes at one year had not spread beyond the breast, with similar prognosis if the lesion was biopsied on initial detection.”

Barr said extending the follow-up imaging interval from six to 12 months for BI-RADS 3 lesions detected by screening ultrasound would substantially decrease the number of follow-up examinations and biopsies performed.

The researchers also found that women in the study with BI-RADS 3 lesions were more likely to be younger than 50 years of age, of Hispanic or Latino ethnicity and pre-menopausal.

Barr is currently conducting additional studies on ultrasound screening and research on the use of elastography, an advanced technique that helps distinguish benign from cancerous lesions.

 

For more information: www.radiologyinfo.org.

Related Content

Theraclion to Launch Metastatic Breast Cancer Trial Combining Echotherapy and Immunotherapy
News | Focused Ultrasound Therapy | September 18, 2017
September 18, 2017 — Theraclion and co-lead investigator David Brenin, M.D., from the University of Virginia School o
DenseBreast-info.org Debuts  Spanish Language Video  About Dense Breasts
News | Breast Density | September 12, 2017
Breast cancer risks associated with breast density are the subject of a new Spanish language video launched recently by...
Asian Study Underlines Potential Value of Pressure-Guided Mammography
News | Mammography | September 11, 2017
Sigmascreening recently announced that a study of in total 15,898 in digital mammograms from 3,772 Asian women...
Delphinus Enrolls First Patient in Discover Breast Ultrasound Clinical Project
News | Ultrasound Womens Healthcare | September 08, 2017
September 8, 2017 — Delphinus Medical Technologies Inc.
Breast imaging X-ray mammogram showing a breast tumor. Photo courtesy of Monthian Ritchan-Ad

Photo courtesy of Monthian Ritchan-Ad

Feature | Breast Density | September 08, 2017 | By Roy Prager, M.D.
While mammograms play a vital role in efforts to identify breast cancer, they can present some challenges in women with...
FDA Clears Senographe Pristina Mammography System With Patient-Assisted Compression
Technology | Mammography | September 05, 2017
The U.S. Food and Drug Administration (FDA) cleared GE Healthcare’s Senographe Pristina with Self-Compression, the...
FDA Releases Six-Month Inspection Data From EQUIP Mammography Quality Initiative
News | Mammography | September 01, 2017
September 1, 2017 — The Division of Mammography Quality Standards (DMQS) of the U.S.
Hologic Announces Availability of Brevera Breast Biopsy System With CorLumina Imaging Technology
Technology | Breast Biopsy Systems | August 31, 2017
Hologic Inc. announced U.S. commercial availability of the Brevera breast biopsy system with CorLumina imaging...
China FDA Approves Xoft Axxent Balloon Applicators for Early-Stage Breast Cancer
News | Brachytherapy Systems, Women's Healthcare | August 30, 2017
iCAD Inc. announced that the company’s Xoft Axxent balloon applicators have received approval from the China Food...
Top list of stories, article, videos for breast imaging.
Feature | Breast Imaging | August 30, 2017 | Dave Fornell
August 30, 2017 — This is a list of the top breast imaging content so far for 2017.
Overlay Init