Korean J Radiol.  2020 Sep;21(9):1027-1035. 10.3348/kjr.2019.0747.

Follow-Up Intervals for Breast Imaging Reporting andData System Category 3 Lesions on Screening Ultrasoundin Screening and Tertiary Referral Centers

Affiliations
  • 1Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Radiology, Severance Check-Up, Seoul, Korea

Abstract


Objective
To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast ImagingReporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution.
Materials and Methods
A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram,BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was30.8 months (range, 6.8–52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathologicalcharacteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chisquareor Fisher’s exact test and continuous variables were compared using the independent t test or Mann-Whitney U test.
Results
In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) werediagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers.In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, twowere ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months andthe remaining eight cancers newly developed after 13.1 months.
Conclusion
One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US foundin screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-upmay be more appropriate.

Keyword

Screening; Breast cancer; Ultrasound; Mammography
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