Clustered microcysts on breast ultrasound benign, don't need biopsy
USA: Lesions characterized as clustered microcysts found on breast ultrasound demonstrate a very low risk of malignancy (can be classified as benign) and do not require a biopsy, a recent study in the journal Radiology has suggested. According to the study, such cysts can be safely tracked with imaging rather than biopsy.
Clustered microcysts are common, especially among perimenopausal women and are seen in about 6% of ultrasound examinations. Despite this, there is limited published data on appropriate management recommendations for clustered microcysts on breast images. Alyssa R. Goldbach, Division of Women's Imaging, Department of Radiology, Temple University Hospital, Philadelphia, PA, and colleagues, therefore, conducted this study to determine outcomes of lesions identified as clustered microcysts on breast US images to help guide appropriate management recommendations.
The study included 189 women (median age, 52 years) with 196 lesions classified as clustered microcysts on ultrasound images. The women were identified in women at two hospitals within one metropolitan health system from 2005 through 2015.
If US-guided tissue sampling was performed, results were obtained from the pathology or cytology reports. If sampling was not performed, only lesions with at least 24 months of imaging follow-up or any imaging follow-up with interval resolution or decrease in size were included in the study.
Key findings of the study include:
· During the surveillance period of at least 24 months and at tissue diagnosis, malignancy was not found in any of the 196 lesions (0%).
· A total of 158 of 196 (80%) lesions were followed with imaging, and 38 of 196 (20%) lesions underwent percutaneous sampling.
· During the follow-up period, 28 of 158 (18%) lesions spontaneously resolved, 13 of 158 (8%) decreased in size, and one of 158 lesions (0.6%) increased at 18-month follow-up but then became stable.
· One hundred sixteen of 158 lesions (73%) demonstrated no change at follow-up imaging, 38 of 196 (19%) lesions underwent percutaneous sampling, and 38 of 38 (100%) revealed benign results.
"There were no malignancies in the study. The results suggest that lesions characterized as clustered microcysts demonstrate a very low risk of malignancy and can be classified as benign. A biopsy may be safely avoided," concluded the authors.
The study, "Clustered Microcysts at Breast US: Outcomes and Updates for Appropriate Management Recommendations," is published in the RSNA journal Radiology.