Routine annual screening for ABUS BI-RADS 3 lesions substantially reduces recall rate: Study
USA: Return to routine screening for BI-RADS 3 lesions on supplemental automated whole-breast US (ABUS) results in a substantial reduction in recall rate without any adverse outcome, suggests results from a recent study in the American Journal of Roentgenology (AJR).
"Results from this prospective study support a recommendation for routine annual follow-up for BI-RADS 3 lesions at supplemental ABUS," wrote the authors.
It is known that supplemental screening breast ultrasound (US) detects additional cancers in women with dense breasts but identifies many BI-RADS 3 lesions that result in short-term follow-ups and biopsies.
Richard G. Barr of Northeastern Ohio Medical University in Rootstown, and colleagues conducted a prospective study from August 2013 to December 2016. The study enrolled patients with BI-RADS 1 or 2 on screening mammography and breast density C or D to undergo supplemental ABUS, which was interpreted as BI-RADS 1, 2, 3, or 0. For ABUS BI-RADS 1, return to routine screening was recommended, whereas ABUS BI-RADS 0 lesions underwent targeted hand-held ultrasound.
In 2,257 women (mean age, 58 years), routine follow-up of BI-RADS 3 lesions detected on supplemental ABUS screening in women with dense breasts and any risk resulted in a recall rate of 3.8% (85/2,257), biopsy rate of 0.5% (12/2,257), and positive biopsy rate of 58.3% (7/12)--with no missed cancers (95% CI, 0.0-0.86%).
Noting that ABUS can help mitigate acquisition variability by standardizing the documentation, recording, and archiving of ultrasound images from the entire breast (excluding the axilla), Barr et al. reiterated that ABUS images of similar quality can be obtained from adequately trained ultrasonographers and mammographers.
"Avoiding earlier follow-up for these probably benign lesions can be associated with substantial cost savings," the authors of this AJR article added.
The study titled, "Outcomes of Return to Routine Screening for BI-RADS 3 Lesions Detected at Supplemental Automated Whole-Breast Ultrasound in Women with Dense Breasts: A Prospective Study," is published in the American Journal of Roentgenology.