ESMO 2019 Congress | OncologyPRO

Abstract 4281

Background

Ultrasound is the first and primary breast screening for thoes women with small and dense breast and is superior to mammography. BI-RADS using ultrasound causes approxinately over 40%-60% false-positive results, unnecessary biopsy and relatively low cancer-to biosy rate. This multi-center study in China is to determine whether contrast-enhanced ultrasound (CEUS) of the breast can improve the precision of BI-RADS.

Methods

1721 patients were enrolled at 8 sites in China. CEUS was performed before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on CEUS performance. Using pathological results as golden standerd to evaluate the diagnostic performance of CEUS-based BI-RADS.

Results

1738 solid breast lesions (5.0-39.8mm, 17.89± 8.65mm) classified as BI-RADS 4 or 5 on conventional ultrasound or mammography. 771/1738(44.36%) are malignant and 967/1738(55.64%) are benign. The CEUS-based BI-RADS evaluation classified 402/1738 (23.13%) lesions into category 3 and its accuracy, sensitivity, specificity, positive and negative predictive values of 65.0%, 97.0%, 40.0%, 56.0% and 94.0%. The cancer-to-biopsy yield was 57.71% with CEUS-based BI-RADS 3 selected as the biopsy threshold compared with 44.36% otherwise, while the total biopsy rate was only 76.87% compared with 100% otherwiseand will reduce 39.5% (382/967) unnecessary biopsy rate in those benign nodules. Overall, only 2.59% of invasive cancers were misdiagnosed similar as BI-RADS 3 we use nowadays.

Conclusions

This study suggests that evaluation of BI-RADS 4 or 5 breast lesions with CEUS result in reduced biopsy rates and increased cancer-to-biopsy yields.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Jun Luo.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.

Resources from the same session

30 Sep 2019