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Third-look contrast-enhanced ultrasonography plus needle biopsy for differential diagnosis of magnetic resonance imaging-only detected breast lesions

  • Special Feature: Review Article
  • Contrast-enhanced Ultrasound: Current Status and Future Prospects
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Research has shown that in approximately 20–30% of cases, breast lesions that were not detected on mammography (MG) or ultrasonography (US) were incidentally found during preoperative magnetic resonance imaging (MRI) examination for breast cancer. MRI-guided needle biopsy is recommended or considered for such MRI-only detected breast lesions invisible on second-look US, but many facilities in Japan cannot perform this biopsy procedure because it is expensive and time consuming. Thus, a simpler and more accessible diagnostic method is needed. Two studies to date have shown that third-look contrast-enhanced US (CEUS) plus needle biopsy for MRI-only detected breast lesions (i.e., MRI + /MG-/US-) that were not detected on second-look US showed moderate/high sensitivity (57.1 and 90.9%) and high specificity (100.0% in both studies) with no severe complications. In addition, the identification rate was higher for MRI-only lesions with a higher MRI BI-RADS category (i.e., category 4/5) than for those with a lower category (i.e., category 3). Despite the fact that there are limitations in our literature review, CEUS plus needle biopsy is a feasible and convenient diagnostic tool for MRI-only lesions invisible on second-look US and is expected to reduce the frequency of MRI-guided needle biopsy. When third-look CEUS does not reveal MRI-only lesions, a further indication for MRI-guided needle biopsy should be considered according to the BI-RADS category.

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Data Availability

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

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Acknowledgements

We thank Angela Morben, DVM, ELS, from Edanz (https://jp.edanz.com/ac), for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, 2-2-E10 Yamada-Oka, Suita-Shi, Osaka, 565-0871, Japan

    Tomohiro Miyake & Kenzo Shimazu

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  1. Tomohiro Miyake
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  2. Kenzo Shimazu
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Correspondence to Tomohiro Miyake.

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TM declares no conflicts of interest. KS has received honoraria and research funding from Daiichi-Sankyo Co., Ltd.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Miyake, T., Shimazu, K. Third-look contrast-enhanced ultrasonography plus needle biopsy for differential diagnosis of magnetic resonance imaging-only detected breast lesions. J Med Ultrasonics (2023). https://doi.org/10.1007/s10396-023-01298-8

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  • DOI: https://doi.org/10.1007/s10396-023-01298-8

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