Synchronous BI-RADS Category 3 Lesions on Preoperative Ultrasonography in Patients with Breast Cancer: Is Short-Term Follow-Up Appropriate?.
10.4048/jbc.2015.18.2.181
- Author:
Seokwon LEE
1
;
Younglae JUNG
;
Youngtae BAE
Author Information
1. Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. bytae@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Breast diseases;
Breast neoplasms;
Multiple primary neoplasms;
Predictive value of tests;
Ultrasonography
- MeSH:
Biopsy, Needle;
Breast;
Breast Diseases;
Breast Neoplasms*;
Follow-Up Studies*;
Humans;
Information Systems;
Logistic Models;
Neoplasms, Multiple Primary;
Predictive Value of Tests;
Receptor, Epidermal Growth Factor;
Receptors, Progesterone;
Risk Factors;
Ultrasonography*;
Ultrasonography, Mammary
- From:Journal of Breast Cancer
2015;18(2):181-186
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Breast ultrasonography (US) has been widely used in the preoperative examination of patients with breast cancer. Breast Imaging Reporting and Data System (BI-RADS) category 3 (C3) lesions (probably benign) are regarded as having a low probability of malignancy (< or =2%). The purposes of this study were to verify the malignancy rates for synchronous BI-RADS C3 lesions in patients with breast cancer and consider appropriate management strategies for these lesions. METHODS: Between January 2010 and January 2013, a total of 161 patients underwent surgery in our institute for breast cancer and synchronous BI-RADS C3 lesions. In the US reports, we found records of 219 synchronous BI-RADS C3 nodules in 161 patients. They were excised during surgery for breast cancer management. Stepwise logistic regression analysis was used to identify predictors of malignancy for synchronous BI-RADS C3 lesions. RESULTS: The rate of malignancy among the 219 BI-RADS C3 lesions was 9.6%. In simple logistic regression analysis, the size of the primary tumor (p<0.001), pathologic T (pT) stage (p=0.002), and progesterone receptor (PR) status of the primary tumor (p=0.029) were significant predictive factors. In multiple logistic regression analysis, the pT stage and PR status of the primary tumor remained significant predictors (p=0.004 and p=0.003, respectively), and human epidermal growth factor receptor 2 (HER2) was identified as another significant factor (p=0.006). CONCLUSION: In patients with breast cancer who are scheduled for surgery, needle biopsy or excision should be considered for synchronous BI-RADS C3 lesions identified on preoperative US when the primary tumor has the following risk factors: large size, high PR expression, and HER2 positivity.
