Skip to main content

Advertisement

SpringerLink
Log in

Follow-up of probably benign lesions in non-screening breast diagnostics

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Our study addresses at the benefit of surveillance of probably benign lesions, detected outside mammographic screening, during a 3-year period.

Methods

28,588 women (mean age 57 ± 12 years) were examined. Two independent radiologists read the mammogram as well as the supplemented ultrasound (in case of breast density ACR type 3 and 4). In the case of discordance a third expert considered whether further examination was indicated or not.

Results

3,266 diagnostic procedures ended with BI-RADS 3 result and 2,512 (76.9 %) women underwent a follow-up examination. 295 (11.7 %) of them received assessment examination (imaging and/or biopsy) and 37 (12.5 %) (none of them palpable) ended with BI-RADS 6. This equals a tumor detection rate of 14.7/1,000. The ratio in situ:invasive was 7:10 (1:1.43) and the mean size was 11.1 ± 4.51 mm. In the total cohort, 536 carcinomas ended with BI-RADS 6 of them 17 % were in situ and 83 % were invasive breast cancers (ratio in situ:invasive 1:4.99), mean size was 13.8 ± 6.3 mm. The cancer detection ratio in these cases was 18.7/1,000.

Conclusions

The amount of detected tumors at follow-up of women with preceding BI-RADS 3 equates the associated potential of malignancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

BI-RADS:

Breast imaging reporting and data system

ACR:

American College of Radiology

RBCP:

Regional breast care project

ADH:

Atypical ductal hyperplasia

LIN:

Lobular intra-epithelial neoplasia

QuaMaDi:

Local quality-assured breast diagnostics program

References

  1. American College of Radiology (1998) Breast imaging reporting and data system (BI-RADS), 3rd edn. American College of Radiology, Raston, pp 94–95

    Google Scholar 

  2. Lehman C, Holt S, Peacock S, White E, Urban N (2002) Use of the American college of radiology BI-RADS guidelines by community radiologists: concordance of assessments and recommendations assigned to screening mammograms. AJR 179:15–20

    Article  PubMed  Google Scholar 

  3. Caplan LS, Blackman D, Nadel M, Monticciolo DL (1999) Coding mammograms using the classification ‘probably benign finding: short interval follow-up suggested’. AJR 172:339–342

    Article  CAS  PubMed  Google Scholar 

  4. Sickles EA (1999) Probably benign breast lesions: when should follow-up be recommended and what is the optimal follow-up protocol? Radiology 213:11–14

    Article  CAS  PubMed  Google Scholar 

  5. Sickles EA (1995) Management of probably benign breast lesions. Radiol Clin North Am 33:1123–1130

    CAS  PubMed  Google Scholar 

  6. Sickles EA (1991) Periodic mammographic follow-up of probably benign lesions: results in 3,184 consecutive cases. Radiology 179:463–468

    Article  CAS  PubMed  Google Scholar 

  7. Varas X, Leborgne F, Leborgne JH (1992) Non palpable, probably benign lesions: role of follow-up mammography. Radiology 184:409–414

    Article  CAS  PubMed  Google Scholar 

  8. Helvie MA, Pennes DR, Rebner M, Adler DD (1991) Mammographic follow-up of low-suspicion lesions: compliance rate and diagnostic yield. Radiology 178:155–158

    Article  CAS  PubMed  Google Scholar 

  9. Varas X, Leborgne JH, Leborgne F, Mezzera J, Jaumandreu S, Leborgne F (2002) Revisiting the mammographic follow-up of BI:RADS category 3 lesions. AJR 179:691–695

    Article  PubMed  Google Scholar 

  10. Vizcaíno I, Gadea L, Andreo L, Salas D, Ruiz-Perales F, Cuenas D, Herranz C, Bueno F, Screening Program Working Group (2001) Short-term follow-up results in 795 nonpalpable probably benign lesions detected at screening mammography. Radiology 219:475–483

    Article  PubMed  Google Scholar 

  11. Burnside ES, Sickles EA, Bassett LW et al (2009) The ACR BI-RADS® experience: learning from history. J Am Coll Radiol 6:851–860

    Article  PubMed Central  PubMed  Google Scholar 

  12. Adler DD, Helvie MA, Ikeda DM (1990) Nonpalpable probably benign breast lesions: follow-up strategies after initial detection on mammography. AJR 155:1195–1201

    Article  CAS  PubMed  Google Scholar 

  13. EUREF European Guidelines for Quality Assurance in Mammography Screening (2001). European Commission, Luxembourg

  14. EUREF European Guidelines for Quality Assurance in Mammography Screening and Diagnosis (2006). European Commission, Luxembourg

  15. Katalinic A, Bartel C, Raspe H, Shreer I (2007) Beyond mammography screening: quality assurance in breast cancer diagnosis (The QuaMaDi Project). Br J Cancer 96:157–161

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Schreer I, Katalinic A (2007) Is high quality breast imaging and diagnosis possible in a decentralized system?. The QuaMaDi project. Breast Care 2:20–24

    Article  Google Scholar 

  17. Albert U-S, Altland H, Duda V et al (2008) Summary of the updated stage 3 guideline for early detection of breast cancer in Germany 2008. Fortschr Röntgenstr 180:455–465

    Article  Google Scholar 

  18. D’Orsi CJ (1992) To follow or not to follow, that is the question. Radiology 184:306

    Article  PubMed  Google Scholar 

  19. Rubin E (1999) Six-month follow-up: an alternative view (viewpoint). Radiology 213:15–18

    Article  CAS  PubMed  Google Scholar 

  20. Hall FM (2002) Malignancy in BI-RADS category 3 mammographic lesions (letter). Radiology 225:918–920

    Article  PubMed  Google Scholar 

  21. Baum JK, Hanna LG, Acharyya S, Mahoney MC, Conant EF, Basset LW, Pisano ED (2011) Use of BI-RADS 3 probably benign category in the American college of radiology imaging network digital mammographic imaging screening trial. Radiology 260(1):61–67

    Article  PubMed Central  PubMed  Google Scholar 

  22. Meyer JE, Kopans DB (1981) Stability of a mammographic mass: a false sense of security. AJR 137:595–598

    Article  CAS  PubMed  Google Scholar 

  23. Liberman L, La Trenta LR, Dershaw DD, Abramson AF, Morris EA, Cohen MA, Rosen PP, Borgen PI (1997) Impact of core biopsy on the surgical management of impalpable breast cancer. AJR 168:495–499

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

First of all, we want to thank the patients for their participation in QuaMaDi program and for their compliance to the periodic surveillance examinations. This publication is a teamwork of 250 people (including doctors and medical staff, as well as the personnel of the Institute of Cancer Epidemiology of the University of Lübeck), who are involved in QuaMaDi project in Schleswig–Holstein. We also thank the participating health care insurance companies, the Ministry of Social Affairs and Health and the Deutsche Krebshilfe e. V., who have financed the program.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Clinic for Radiology and Nuclear Medicine, University Clinic of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160 (Haus 40), 23538, Lübeck, Germany

    Smaragda Kapsimalakou, Isabell Grande-Nagel, Joerg Barkhausen & Florian M. Vogt

  2. Institute of Clinical Epidemiology, University Clinic of Schleswig-Holstein, Ratzeburger Allee 160 (Haus 50), 23538, Lübeck, Germany

    Annika Waldmann & Alexander Katalinic

  3. Clinic for Gynecology and Obstetrics, University Clinic of Schleswig-Holstein, Ratzeburger Allee 160 (Haus 12,16), 23538, Lübeck, Germany

    Dorothea Fischer

Authors
  1. Smaragda Kapsimalakou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annika Waldmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexander Katalinic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Isabell Grande-Nagel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dorothea Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Joerg Barkhausen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Florian M. Vogt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Florian M. Vogt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kapsimalakou, S., Waldmann, A., Katalinic, A. et al. Follow-up of probably benign lesions in non-screening breast diagnostics. Arch Gynecol Obstet 290, 543–551 (2014). https://doi.org/10.1007/s00404-014-3233-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-014-3233-5

Keywords

Search

Navigation