USA: Ultrasound alone is more effective for working up of masses identified on screening digital breast tomosynthesis (DBT), suggests a recent study in the European Journal of Radiology (EJR). This means that masses recalled from screening DBT are more likely to be resolved entirely by ultrasound.
According to the study, masses recalled from screening DBT is more likely to represent true lesions whereas recalled asymmetries and focal asymmetries were more likely to be worked up with diagnostic mammography.
Jessica H. Porembka, University of Texas Southwestern Medical Center Dallas, TX, USA, and colleagues compared the use of diagnostic mammography, diagnostic mammography with ultrasound, and ultrasound alone in the evaluation of recalled non-calcified lesions from screening mammography with DBT.
The researchers performed a retrospective review of recalled non-calcified lesions that included mass from screening DBT, focal asymmetry, asymmetry, and architectural distortion. Electronic health records were reviewed for imaging evaluations, findings and histopathology results.
Key findings of the study include:
Of 266 non-calcified lesions in 247 women, masses were significantly more likely to be evaluated with ultrasound alone compared to diagnostic mammography with ultrasound than all other recalled finding types.
Architectural distortions were more likely to be assigned a BI-RADS 4 or 5 on the diagnostic evaluation than all other lesion types.
Masses were more likely to be true lesions (90 %; 111/124) compared to 40 % (23/57) of focal asymmetries and 24 % (16/67) of asymmetries).
No significant difference was noted in the malignant versus benign biopsy outcomes among the recalled DBT lesion types.
Based on the findings the authors concluded that recalled masses from screening DBT are more likely to be worked up with ultrasound alone compared to all other non-calcified lesion types and more likely to represent true lesions on diagnostic evaluation. Recalled asymmetries and focal asymmetries were more likely to be worked up with either diagnostic mammography with ultrasound or diagnostic mammography alone.
The study, "Choice of imaging method in the work-up of non-calcified breast lesions identified on tomosynthesis screening," is published in the European Journal of Radiology.
DOI: https://doi.org/10.1016/j.ejrad.2020.109203