Screening Breast Ultrasound: Past, Present, and Future

Brem, Rachel F.; Lenihan, Megan J.; Lieberman, Jennifer H.; Torrente, Jessica

doi:10.2214/ajr.13.12072

Cited by 232 publications

(146 citation statements)

References 29 publications

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“…It is beneficial for detecting small size cancers when they are at an earlier stage rather than they would have been if they had been detected later as interval cancers [14,15]. However, the detection of additional cancers is associated with a substantial callback rate as well as an increased false positive biopsy rate [16].…”

Section: Discussionmentioning

confidence: 99%

“…However, the detection of additional cancers is associated with a substantial callback rate as well as an increased false positive biopsy rate [16]. Several studies show low PPV and do not meet the 25-40% PPV of biopsy recommended by the US agency for Health care Policy and Research [14]. Advances in US image quality and increasing utility of bilateral whole breast US have allowed the detection of a hypoechoic area that does not meet the criteria of a mass in clinical settings and they include various spectrum, such as duct changes, architectural distortion, and non-mass lesions.…”

Section: Discussionmentioning

confidence: 99%

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Non-mass lesions on screening breast ultrasound

Lee

Baik

et al. 2016

Med Ultrason

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Aim: The purpose of this study was to determine the significance of a non-mass lesion (NML) which is recognized during screening breast ultrasound (US). Materials and methods: We included patients with a NML on screening breast US and no suspicious finding on mammography between March 2008 and June 2012. The final diagnoses were based on pathology results and a clinical or sonographic follow-up for more than 12 months. We calculated the incidence, likelihood of malignancy, and positive predictive value (PPV) of biopsy with a review of imaging and histopathological findings. Results: A total of 17868 screening breast US were performed in 8856 asymptomatic patients. Ninety-five NMLs were detected in 88 patients (1.0%). Among the 93 lesions that were followed or confirmed histopathologically, 2 (2.2%) were malignant, 89 (95.6%) were benign, and 2 (2.2%) were high risk lesions. The likelihood of malignancy in a NML on screening breast US was 2.2% and the PPV of biopsy was 6.3% (2 of 32). Conclusion: The likelihood of malignancy for a NML on screening breast US was greater than 2%. It could be classified as a BI-RADS category 4a lesion and tissue diagnosis is warranted. This provides the potential management guidelines for a NML in screening patients and further prospective studies in a large, multicenter screening population are required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Non-mass lesions on screening breast ultrasound

Lee

Baik

et al. 2016

Med Ultrason

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“…The main limitations of screening ultrasound are a high rate of false-positive results and dependence on operator expertise (12). The high rate of false-positive results (and the low positive predictive value) of ultrasound has not yet met the minimum standard recommended by the Ultrasound Agency for Health Care Policy and Research (13). Concerning other screening modalities, some of which are discussed elsewhere in this supplement, the current American College of Radiology appropriateness criteria state, "There is insufficient evidence to support the use of [additional screening] imaging modalities such as thermography, breast-specific gamma imaging, positron emission mammography, and optical imaging" (14).…”

Section: Breast Cancer Diagnosis Screeningmentioning

confidence: 99%

Clinical Diagnosis and Management of Breast Cancer

et al. 2016

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The diagnosis and management of breast cancer are undergoing a paradigm shift from a one-size-fits-all approach to an era of personalized medicine. Sophisticated diagnostics, including molecular imaging and genomic expression profiles, enable improved tumor characterization. These diagnostics, combined with newer surgical techniques and radiation therapies, result in a collaborative multidisciplinary approach to minimizing recurrence and reducing treatment-associated morbidity. This article reviews the diagnosis and treatment of breast cancer, including screening, staging, and multidisciplinary management. In this article, we address current approaches to breast cancer diagnosis and management. These approaches include screening recommendations; diagnostic imaging and pathologic assessment to determine the extent of disease; surgery and radiation treatment; and an array of systemic options, such as chemotherapy, endocrine therapy, and targeted agents (Fig. 1). We also consider the potential contribution of functional imaging to a new era of personalized, tumor-specific treatment. BREAST CANCER DIAGNOSIS ScreeningBreast cancer is generally diagnosed through either screening or a symptom (e.g., pain or a palpable mass) that prompts a diagnostic exam. Screening of healthy women is associated with the detection of tumors that are smaller, have lower odds of metastasis, are more amenable to breast-conserving and limited axillary surgery, and are less likely to require chemotherapy (1). This scenario translates to reduced treatment-related morbidity and improved survival.The only screening modality proven to reduce breast cancerspecific mortality is mammography (2). Screening mammography leads to a 19% overall reduction in breast cancer mortality (3), with less benefit for women in their 40s (15%) and more benefit for women in their 60s (32%). As a result, screening mammography is recommended by the American Cancer Society beginning at age 45, or sooner depending on individual preference. The potential negative aspects of screening mammography are falsepositive examinations, radiation exposure, pain, anxiety, and other negative psychologic effects. Mammography has a 61% chance of a false-positive result over a 10-y period for women commencing screening between the ages of 40 y and 50 y. The risk of a falsepositive examination decreases with older age (3). The US Preventative Task Force cited a 15% breast cancer-related mortality reduction for women who were 39-49 y old and a mortality-related benefit from screening between ages 39 and 69. However, the task force released a controversial report recommending only biennial screening mammography for women who were 50-74 y old, excluding younger women to a large extent because of the high rate of false-positive results (4). Mammography for women in the 39-to 49-y-old age group was recommended if indicated after the use of a risk-based model of breast cancer screening, such as the models developed by the Population-Based Research Optimizing Screening Through Personalized Re...

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“…[2][3][4][5][6][7] Of the techniques available, magnetic resonance imaging (MRI) has consistently demonstrated superior sensitivity to conventional imaging techniques for breast cancer detection. 8,9 In this regard, a recent meta-analysis of 44 studies revealed an overall sensitivity of 0.90 for MRI in the evaluation of breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of gadobenate dimeglumine in contrast-enhanced MRI of the breast: a review

Luciani¹,

Telesca²,

Kirchin³

et al. 2015

RRNM

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Breast magnetic resonance imaging (MRI) is considered the technique with the highest sensitivity for breast cancer detection. Gadobenate dimeglumine is a gadolinium-based contrast agent (GBCA) that is specifically approved in Europe for breast MRI and which has the highest r1 relaxivity among all GBCAs for this indication. In order to improve the diagnostic performance of breast MRI, several intra-individual crossover studies have evaluated gadobenate dimeglumine as a possible GBCA for this application. This review focuses on the role and advantages of gadobenate dimeglumine as a contrast agent for breast MRI by describing the unique properties of this agent and by summarizing published studies.

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Screening Breast Ultrasound: Past, Present, and Future

Cited by 232 publications

References 29 publications

Non-mass lesions on screening breast ultrasound

Non-mass lesions on screening breast ultrasound

Clinical Diagnosis and Management of Breast Cancer

Clinical utility of gadobenate dimeglumine in contrast-enhanced MRI of the breast: a review

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