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    Magnetic Resonance Imaging-Directed Ultrasound Imaging of Non-Mass Enhancement in the Breast: Outcomes and Frequency of Malignancy

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    Authors
    Newburg, Adrienne
    Chhor, Chloe M.
    Young Lin, Leng Leng
    Heller, Samantha L.
    Gillman, Jennifer
    Toth, Hildegard K.
    Moy, Linda
    UMass Chan Affiliations
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2017-03-01
    Keywords
    breast ultrasound
    correlate
    magnetic resonance imaging-directed ultrasound
    non-mass enhancement
    Radiology
    
    Metadata
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    Link to Full Text
    https://doi.org/10.7863/ultra.16.03001
    Abstract
    OBJECTIVES: This study was performed to determine the frequency, predictors, and outcomes of ultrasound (US) correlates for non-mass enhancement. METHODS: From January 2005 to December 2011, a retrospective review of 5837 consecutive breast magnetic resonance imaging examinations at our institution identified 918 non-mass enhancing lesions for which follow-up or biopsy was recommended. Retrospective review of the images identified 879 of 918 lesions (96%) meeting criteria for non-mass enhancement. Patient demographics, pathologic results, and the presence of an adjacent landmark were recorded. Targeted US examinations were recommended for 331 of 879 cases (38%), and 284 of 331 women (86%) underwent US evaluations. RESULTS: The US correlate rate for non-mass enhancement was 23% (64 of 284). An adjacent landmark was significantly associated with a US correlate (P < .001). Biopsy was recommended for 43 of 64 correlates (67%). Ultrasound-guided biopsy was performed on 39 of 43 (91%); 7 of 39 (18%) were malignant. No correlate was seen for 220 of 284 lesions (77%). At magnetic resonance imaging-guided biopsy, 14 of 117 (12%) were malignancies. For all biopsied non-mass enhancements, the malignancy rate was 18% (55 of 308) and was significantly more prevalent in the setting of a known index cancer (P < .001), older age (P < .001), the presence of a landmark (P = .002), and larger lesion size (P = .019). CONCLUSIONS: Non-mass enhancement with an adjacent landmark is more likely to have a US correlate compared to non-mass enhancement without an adjacent landmark. Non-mass enhancement in the setting of a known index cancer, older age, a landmark, and larger lesion size is more likely to be malignant. However, no statistical difference was detected in the rate of malignancy between non-mass enhancement with (18%) or without (12%) a correlate. Absence of a correlate does not obviate the need to biopsy suspicious non-mass enhancement.
    Source
    J Ultrasound Med. 2017 Mar;36(3):493-504. doi: 10.7863/ultra.16.03001. Epub 2017 Jan 21. Link to article on publisher's site
    DOI
    10.7863/ultra.16.03001
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48223
    PubMed ID
    28108994
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.7863/ultra.16.03001
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