3614: Palpable breast lesions with benign morphology at US: Can follow-up be an acceptable alternative to biopsy?

Abstract

Objectives: To determine the negative predictive value of sonography in evaluating palpable breast lesions with benign morphology and whether follow-up is acceptable alternative to biopsy. Methods: Of the 1399 sonograms for palpable masses from January 2004 to September 2005, there were 397 patients having masses with benign morphology. Of them, this study included 274 patients (age range, 12 to 64y; mean age, 34y) with 312 palpable lesions that were pathologically confirmed. Fine-needle aspiration (n = 7), US-guided core needle biopsy (n = 181) or surgical biopsy (n = 124) was performed for pathologic correlation. P-values and one-sided 95% confidence interval were calculated by one-sided test in a sample for proportion, using statistical software package SPSS for Windows version 12.0. P < 0.05 was considered to indicate statistical significance. Results: Of the 312 masses, there were 310 benign lesions and two malignancies (0.6%), for a negative predictive value of 99.4%. At statistical analysis, frequency of cancer is less than 2% (p value = 0.0432, 95% confidence interval: -0.2 ∾ 1.5%). Conclusions: The negative predictive value of sonography for palpable breast masses with benign morphology is high (99.4%). Palpable breast lesions with benign morphology at US can be managed similarly to nonpalpable probably benign lesions, with short-term follow-up alternative to prompt biopsy.