Value of second-look ultrasound of suspicious breast lesion detected on MRI

Abstract

OBJECTIVE: The purpose of this study was to evaluate the clinical utility of a targeted ultrasound examination in the analysis of suspicious breast lesions detected initially on MRI. ----- MATERIALS AND METHODS: This retrospective study was conducted analysing the radiology reports of 25 patients with biopsy-proven breast cancer. Patients underwent MRI as part of the preoperative workup. Newly detected lesions on MRI were subsequently evaluated by ultrasound. Percutaneous biopsy and cytopuncture were performed on suspicious lesions. Correlation of MR and ultrasound findings was compared with respect to the lesion type, size and morphological characteristics. ----- RESULTS: A total of 33 new lesions were detected on MRI. Ultrasound correlation was made in 25 lesions (75,8%). Out of 25 lesions detected on ultrasound, 15 underwent biopsy or cytopuncture. 9 lesions (36,0%) were pathohistologically confirmed as malignant and 16 (64,0%) had benign characteristics. Correlation rate of MR and ultrasound findings was significantly higher in mass lesions (p<0,05). No correlation was found for focal lesions. Size of other lesions did not affect correlation rate. MRI-detected suspicious morphological features (irregular shape, non-circumscribed margin, heterogenous/rim/clumped enhancement pattern) did not influence correlation, but were shown to be a good predictor of malignancy. ----- CONCLUSION: Targeted ultrasound is an excellent diagnostic method for detection as well as evaluation of lesions detected initially on MRI examination. It is a valuable aid in clinical decision making. Lesion type affects the correlation rate of MR and ultrasound findings, unlike the lesion size and suspicious MRI morphological features. Usage of targeted ultrasound can significantly reduce the number of unnecessary biopsies.