Brendan O'Shea MD, Presenter: Nothing to Disclose

Jeong Mi Park MD, Abstract Co-Author: Nothing to Disclose

Warren Scott Spencer MD, Abstract Co-Author: Nothing to Disclose

Gregory Durst MD, Abstract Co-Author: Nothing to Disclose

Justin Boatsman MD, Abstract Co-Author: Nothing to Disclose

Limin Yang MD, PhD, Abstract Co-Author: Nothing to Disclose

To help provide a follow-up management guideline for solid BIRADS 3 breast ultrasound (US) lesions

151 pure solid breast US lesions in 122 patients with follow-up US at least once. Retrospective analysis was done for their US characteristics and final outcome.  

Mean age:36.5. Mean longest diameter: 1.36 cm. Reasons for exam: palpable mass (n=120), imaging-only abnormality (n=28), nipple discharge (n=3). US shape: Oval (n=146), round (n=1), irregular (n=4). Echogenicity : hypoechoic (n=94), isoechoic (n=42), hyperechoic (n=3), mixed echoic (n=12). Borders: well circumscribed (n=147), ill defined (n= 4). 32 lesions in 30 patients had biopsy (17 Core biopsy, 12 FNA, 3 excision). Final pathology: benign (n=31), cancer (n=1). 30 lesions were palpable. 13 lesions were recommended for a biopsy at the first F/U (mean FU 5.3 mo., 41%) and 3 lesions were recommended for a biopsy at the second F/U (mean FU 11 mo., 9%). Other 16 lesions were stable on imaging, but biopsied for a clinical concern. Among 63 lesions followed up a second time, 3 were recommended for a biopsy (5%). For the 119 lesions that were not biopsied (Mean F/U 10.5 mo.), no significant changes in the US findings were seen, no further clinical management was performed thereafter.   

If a pure solid breast lesion shows typical benign-appearing US characteristics, the possibility of cancer is extremely low. Our data show that 50% of biopsied lesions showed changes within 11 months of F/U period and 95% of lesions followed up second time were stable, suggesting that lesions that would need biopsy show the changes earlier and lesions stable at the first F/U are likely stable thereafter. Palpability did not affect the outcome.

Although larger series is necessary to confirm our results, solid breast lesions demonstrating benign features may be interpreted as benign at 12 months F/U, regardless of palpability.

O'Shea, B, Park, J, Spencer, W, Durst, G, Boatsman, J, Yang, L, BIRADS 3 Solid Breast Lesions on Ultrasound: A Suggested Guideline for Follow-up Management  .  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12026693.html