The Breast Cancer News Update: July 8

Today in breast cancer news, we'll share the latest research on the accuracy of diagnostic ultrasound. As always, all of the research discussed below can be found on the diagnostic ultrasound page of the LATESTBreastCancer.com website.

After a screening mammogram is read by a radiologist, it's not uncommon for a woman to be recalled for a diagnostic ultrasound to further examine a suspicious finding. Understandably, it can be a stressful event. Even after a negative ultrasound where no malignancy is found, some women continue to worry and wonder about the accuracy of the ultrasound. Three recent research papers addressed these concerns.

BI-RADS assessments are consistent among experienced radiologists

Ultrasound findings are classified using a Breast Imaging Reporting and Data System known as BI-RADS. Using something like the American College of Radiology BI-RADS form, a radiologist can check boxes to reflect ultrasound findings on mass size and shape, margins, vascularity, surrounding tissue, echo patterns, etc. At the bottom of the form, radiologists assign a number to classify their findings. Scores range from Category 1, meaning the findings are benign to Category 5, almost certainly malignant. A Category 0 is an inconclusive result. Category 6 means that malignancy has been confirmed by biopsy.

Because the assignment of a BI-RADS score involves a certain amount of subjectivity, some may question the accuracy of the score. In a June 6 study from China published in the European Journal of Radiology, 12 radiologists reviewed 60 ultrasound images (two images of thirty lesions) and assigned each a BI-RADS score. The researchers found that among experienced radiologists, BI-RADS assessments were accurate and consistent. However "diagnostic agreement" decreased as breast imaging experienced decreased.

Diagnostic ultrasound false-negatives

An Australian study published June 29 in Clinical Radiology examined ultrasound false-negative rates and factors. The researchers examined the records of 646,692 women who received screening mammograms over a 10 year period. From a group of 34,533 women recalled for further assessment, 46 patients who received a diagnostic ultrasound were diagnosed with cancer within the next 24 months. Of these, 10 were true false-negatives, meaning that the cancer existed at the time of ultrasound, but was erroneously classified as benign. 15 were true interval cancers, which did not exist at the time of diagnostic ultrasound. For 21 women, the ultrasound assessment was correct, but cancer diagnosis was delayed either due to a delay in obtaining a biopsy or a "non-diagnostic initial biopsy." Based on these findings, the authors conclude that a "normal ultrasound examination should not deter the radiologist from proceeding to stereotactic biopsy, if the index mammographic lesion is suspicious of malignancy."

Ultrasound of clustered microcalcifications

A June 30 study from Taiwan published in Breast (Edinburgh, Scotland) examined the accuracy of diagnostic ultrasound when clustered microcalcifications are found on screening mammography. The study evaluated the diagnostic ultrasound findings of 142 cases with clustered microcalcifications on mammogram. The authors found that ultrasound "was significantly more sensitive for the identification of malignant cases but biopsy of clustered microcalcifications is still warranted when targeted-ultrasound revealed negative findings."

At LATESTBreastCancer.com, we don't just provide access to the latest news and research on a breast cancer test or treatment option. We also provide links to helpful descriptions, videos or overviews. For example, under the Descriptions tab of the diagnostic ultrasound page, you'll find links to 11 overviews of diagnostic breast ultrasound.

Please check back Monday for more news and research highlights. In the meantime, feel free to explore the latest news and research on all breast cancer test and treatment options on the LATESTBreastCancer.com website anytime.