Skip to main content

Advertisement

SpringerLink
Log in

Performance of hand-held whole-breast ultrasound based on BI-RADS in women with mammographically negative dense breast

  • Breast
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To assess the performance of breast ultrasound based on BI-RADS final assessment categories in women with mammographically negative dense breast.

Methods

Of 3,820 cases with mammographically negative dense breast and subsequent hand-held bilateral whole-breast ultrasound, a total of 1,507 cases in 1,046 women who had biopsy or at least 2-year follow-up ultrasound constituted the basis of this retrospective study. Cancer rate of each sonographic BI-RADS category was determined and medical audit was performed separately in screening-general, screening-treated, and diagnostic group.

Results

A total of 43 cases (2.9%) were confirmed as malignancy. Cancer rate among BI-RADS categories was significantly different (p < 0.0001). Among three groups, the cancer rate was significantly different (p < 0.0001) and the highest in diagnostic group (15.8%, 22 of 139). Abnormal interpretation rate, PPV of biopsy performed, cancer detection rate, and rate of early stage cancer, and the size of invasive cancer were significantly different among three groups and the highest in diagnostic group. Regarding cancer characteristics, the proportion of advanced cancer was the highest in diagnostic group.

Conclusion

Breast ultrasound based on BI-RADS as an adjunctive to negative mammography can be useful for predicting malignancy in women with dense breast.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Berg WA (2004) Supplemental screening sonography in dense breasts. Radiol Clin North Am 42:845–851

    Article  PubMed  Google Scholar 

  2. Corsetti V, Ferrari A, Ghirardi M, Bergonzini R, Bellarosa S, Angelini O, Bani C, Ciatto S (2006) Role of ultrasonography in detecting mammographically occult breast carcinoma in women with dense breasts. Radiol Med 111:440–448

    Article  PubMed  CAS  Google Scholar 

  3. Corsetti V, Houssami N, Ferrari A, Ghirardi M, Bellarosa S, Angelini O, Bani C, Sardo P, Remida G, Galligioni E, Ciatto S (2008) Breast screening with ultrasound in women with mammography-negative dense breasts: evidence on incremental cancer detection and false positives, and associated cost. Eur J Cancer 44:539–544

    PubMed  Google Scholar 

  4. Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Bohm-Velez M, Pisano ED, Jong RA, Evans WP, Morton MJ, Mahoney MC, Larsen LH, Barr RG, Farria DM, Marques HS, Boparai K (2008) Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 299:2151–2163

    Article  PubMed  CAS  Google Scholar 

  5. Feig SA (2005) Current status of screening US. In: Feig SA (ed) 2005 Syllabus: categorical course in diagnostic radiology-breast imaging. Radiological Society of North America, Oak Brook, pp 143–154, Il

    Google Scholar 

  6. Berg WA (2009) Tailored supplemental screening for breast cancer: what now and what next? AJR Am J Roentgenol 192:390–399

    Article  PubMed  Google Scholar 

  7. American College of Radiology (2003) Breast imaging reporting and data system. American College of Radiology, Reston

    Google Scholar 

  8. Lazarus E, Mainiero MB, Schepps B, Koelliker SL, Livingston LS (2006) BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology 239:385–391

    Article  PubMed  Google Scholar 

  9. Hong AS, Rosen EL, Soo MS, Baker JA (2005) BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR Am J Roentgenol 184:1260–1265

    PubMed  Google Scholar 

  10. Costantini M, Belli P, Lombardi R, Franceschini G, Mule A, Bonomo L (2006) Characterization of solid breast masses: use of the sonographic breast imaging reporting and data system lexicon. J Ultrasound Med 25:649–659

    PubMed  Google Scholar 

  11. Costantini M, Belli P, Ierardi C, Franceschini G, La Torre G, Bonomo L (2007) Solid breast mass characterisation: use of the sonographic BI-RADS classification. Radiol Med 112:877–894

    Article  PubMed  CAS  Google Scholar 

  12. Lee HJ, Kim EK, Kim MJ, Youk JH, Lee JY, Kang DR, Oh KK (2008) Observer variability of breast imaging reporting and data system (BI-RADS) for breast ultrasound. Eur J Radiol 65:293–298

    Article  PubMed  Google Scholar 

  13. Kim EK, Ko KH, Oh KK, Kwak JY, You JK, Kim MJ, Park BW (2008) Clinical application of the BI-RADS final assessment to breast sonography in conjunction with mammography. AJR Am J Roentgenol 190:1209–1215

    Article  PubMed  Google Scholar 

  14. Heinig J, Witteler R, Schmitz R, Kiesel L, Steinhard J (2008) Accuracy of classification of breast ultrasound findings based on criteria used for BI-RADS. Ultrasound Obstet Gynecol 32:573–578

    Article  PubMed  CAS  Google Scholar 

  15. Raza S, Chikarmane SA, Neilsen SS, Zorn LM, Birdwell RL (2008) BI-RADS 3, 4, and 5 lesions: value of US in management–follow-up and outcome. Radiology 248:773–781

    Article  PubMed  Google Scholar 

  16. Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA (1995) Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 196:123–134

    PubMed  CAS  Google Scholar 

  17. Parikh J, Tickman R (2005) Image-guided tissue sampling: where radiology meets pathology. Breast J 11:403–409

    Article  PubMed  Google Scholar 

  18. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2010) AJCC cancer staging manual. Springer-Verlag, New York

    Google Scholar 

  19. Weinstein SP, Localio AR, Conant EF, Rosen M, Thomas KM, Schnall MD (2009) Multimodality screening of high-risk women: a prospective cohort study. J Clin Oncol 27:6124–6128

    Article  PubMed  Google Scholar 

  20. Sohlich RE, Sickles EA, Burnside ES, Dee KE (2002) Interpreting data from audits when screening and diagnostic mammography outcomes are combined. AJR Am J Roentgenol 178:681–686

    PubMed  Google Scholar 

  21. Kolb TM, Lichy J, Newhouse JH (1998) Occult cancer in women with dense breasts: detection with screening US–diagnostic yield and tumor characteristics. Radiology 207:191–199

    PubMed  CAS  Google Scholar 

  22. Kolb TM (2004) Breast US for screening diagnosing, and staging breast cancer: issues and controversies. In: Karellas A (ed) RSNA Categorical course in diagnostic radiology physics: advances in breast imaging-physics, technology, and clinical applications. Radiological Society of North America, Oakbrook, pp 247–257, Il

    Google Scholar 

  23. Leconte I, Feger C, Galant C, Berliere M, Berg BV, D’Hoore W, Maldague B (2003) Mammography and subsequent whole-breast sonography of nonpalpable breast cancers: the importance of radiologic breast density. AJR Am J Roentgenol 180:1675–1679

    PubMed  Google Scholar 

  24. Bassett L, Winchester DP, Caplan RB, Dershaw DD, Dowlatshahi K, Evans WP 3rd, Fajardo LL, Fitzgibbons PL, Henson DE, Hutter RV, Morrow M, Paquelet JR, Singletary SE, Curry J, Wilcox-Buchalla P, Zinninger M (1997) Stereotactic core-needle biopsy of the breast: a report of the Joint Task Force of the American College of Radiology, American College of Surgeons, and College of American Pathologists. CA Cancer J Clin 47:171–190

    Article  PubMed  CAS  Google Scholar 

  25. Dee KE, Sickles EA (2001) Medical audit of diagnostic mammography examinations: comparison with screening outcomes obtained concurrently. AJR Am J Roentgenol 176:729–733

    PubMed  CAS  Google Scholar 

  26. Nothacker M, Duda V, Hahn M, Warm M, Degenhardt F, Madjar H, Weinbrenner S, Albert US (2009) Early detection of breast cancer: benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review BMC Cancer 9:335

    Article  Google Scholar 

  27. Sickles EA, Miglioretti DL, Ballard-Barbash R, Geller BM, Leung JW, Rosenberg RD, Smith-Bindman R, Yankaskas BC (2005) Performance benchmarks for diagnostic mammography. Radiology 235:775–790

    Article  PubMed  Google Scholar 

  28. Rosenberg RD, Yankaskas BC, Abraham LA, Sickles EA, Lehman CD, Geller BM, Carney PA, Kerlikowske K, Buist DS, Weaver DL, Barlow WE, Ballard-Barbash R (2006) Performance benchmarks for screening mammography. Radiology 241:55–66

    Article  PubMed  Google Scholar 

  29. Bassett LW, Jackson VP, Fu KL, Fu YS (2005) The medical audit. In: Ross A, Pontee E (eds) Diagnosis of diseases of the breast, 2nd edn. Elsevier Saunders, Philadelphia, pp 135–148

    Google Scholar 

  30. Houssami N, Lord SJ, Ciatto S (2009) Breast cancer screening: emerging role of new imaging techniques as adjuncts to mammography. Med J Aust 190:493–497

    PubMed  Google Scholar 

  31. Weaver DL, Rosenberg RD, Barlow WE, Ichikawa L, Carney PA, Kerlikowske K, Buist DS, Geller BM, Key CR, Maygarden SJ, Ballard-Barbash R (2006) Pathologic findings from the Breast Cancer Surveillance Consortium: population-based outcomes in women undergoing biopsy after screening mammography. Cancer 106:732–742

    Article  PubMed  Google Scholar 

  32. Quality Determinants of Mammography Guideline Panel (1994) Quality determinants of mammography. AHCPR Publication no. 95-0632. U.S. Department of Health and Human Services, Public Health Service, Rockville, Md

  33. Kelly KM, Dean J, Comulada WS, Lee SJ (2010) Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts. Eur Radiol 20:734–742

    Article  PubMed  Google Scholar 

  34. Bevers TB (2008) Ultrasound for the screening of breast cancer. Curr Oncol Rep 10:527–528

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2009-0138)

Author information

Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seodaemun-ku, Shinchon-dong 134, Seoul, 120-752, South Korea

    Ji Hyun Youk, Eun-Kyung Kim, Min Jung Kim, Jin Young Kwak & Eun Ju Son

Authors
  1. Ji Hyun Youk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eun-Kyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Min Jung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jin Young Kwak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eun Ju Son
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eun-Kyung Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Youk, J.H., Kim, EK., Kim, M.J. et al. Performance of hand-held whole-breast ultrasound based on BI-RADS in women with mammographically negative dense breast. Eur Radiol 21, 667–675 (2011). https://doi.org/10.1007/s00330-010-1955-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-1955-8

Keywords

Search

Navigation