(Press-News.org) OAK BROOK, Ill. – Based on data from a multi-site imaging trial involving more than 2,600 women, researchers say breast lesions categorized as 'probably benign' on supplemental screening ultrasound could be re-evaluated with imaging in 12 months, reducing patient anxiety, follow-up exams and unnecessary biopsies. Results of the study are published online in the journal Radiology.
In the study, a team of researchers analyzed data from the American College of Radiology Imaging Network (ACRIN) trial 6666, in which both annual mammography and ultrasound screenings were performed on women with dense breasts at 21 sites around the country. Ultrasound is increasingly being used as a supplement to screening mammography because it is able to detect breast cancers that may not be visible with mammography, especially in dense breasts.
"Supplemental ultrasound screening increases cancer detection beyond mammography alone, but may also result in an increased number of additional tests," said lead researcher Richard G. Barr, M.D., Ph.D., professor of radiology at the Northeast Ohio Medical University in Youngstown, Ohio. "Both screening ultrasound and screening mammography have similar issues: to find breast cancers, a large number of biopsies must be performed, most of which turn out to be negative."
Dr. Barr and colleagues analyzed the trial's ultrasound-detected lesions assessed as probably benign or category 3 of the Breast Imaging-Reporting and Data System (BI-RADS), a standardized system of assessing breast lesions and their probability of malignancy based on appearance, to determine the prevalence and malignancy rate of these lesions.
Guidelines suggest that BI-RADS 3 lesions should be monitored for suspicious changes with additional imaging at intervals of six, 12 and 24 months.
"BI-RADS 3 lesions are common on screening ultrasound and often lead to unnecessary biopsies and additional imaging, causing substantial cost and anxiety for patients," Dr. Barr said. "We wanted to study these BI-RADS 3 lesions to look for ways to perform fewer biopsies without missing breast cancers."
The researchers analyzed the screening ultrasound exams and follow-up data of 2,662 trial participants recruited between 2004 and 2006. Of the 2,662 women, 519 had a total of 745 BI-RADS 3 lesions, representing 25 percent of all ultrasound-detected lesions in the study.
Of the 745 BI-RADS 3 lesions, six were malignant for a total malignancy rate of 0.8 percent. The average size of the detected cancers among the BI-RADS 3 lesions was 10 millimeters.
During six-month follow-up imaging, suspicious changes were observed in only one of the 745 BI-RADS 3 lesions. At 12-month follow-up imaging, suspicious changes were observed in a second BI-RADS 3 lesion, revealing an invasive breast cancer that had not yet spread beyond the breast.
"As a result of the low malignancy rate of BI-RADS 3 lesions and the low rate of suspicious changes at six-month follow-up imaging, yearly follow-up for these lesions may be appropriate," Dr. Barr said. "The cancers detected due to changes at one year had not spread beyond the breast, with similar prognosis if the lesion was biopsied on initial detection."
Dr. Barr said extending the follow-up imaging interval from six to 12 months for BI-RADS 3 lesions detected by screening ultrasound would substantially decrease the number of follow-up examinations and biopsies performed.
The researchers also found that women in the study with BI-RADS 3 lesions were more likely to be younger than 50 years of age, of Hispanic or Latino ethnicity and pre-menopausal.
Dr. Barr is currently conducting additional studies on ultrasound screening and research on the use of elastography, an advanced technique that helps distinguish benign from cancerous lesions.
###
"Probably Benign Lesions at Screening Breast US in a Population with Elevated Risk: Prevalence and Rate of Malignancy in the ACRIN 6666 Trial." Collaborating with Dr. Barr were Zheng Zhang, Ph.D., Jean B. Cormack, Ph.D., Ellen B. Mendelson, M.D., and Wendie A. Berg, M.D., Ph.D. The Avon Foundation and grants from the National Cancer Institute funded the study.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.
RSNA is an association of more than 51,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on breast ultrasound, visit RadiologyInfo.org.
Multicenter trial finds BI-RADS 3 breast lesions have low cancer rate
2013-08-20
ELSE PRESS RELEASES FROM THIS DATE:
Bacterial toxins cause deadly heart disease
2013-08-20
University of Iowa researchers have discovered what causes the lethal effects of staphylococcal infective endocarditis - a serious bacterial infection of heart valves that kills approximately 20,000 Americans each year.
According to the UI study, the culprits are superantigens -- toxins produced in large quantities by Staphylococcus aureus (staph) bacteria - which disrupt the immune system, turning it from friend to foe.
"The function of a superantigen is to 'mess' with the immune system," says Patrick Schlievert, Ph.D., UI professor and chair of microbiology at the ...
Target 2 forms of iron to control cystic fibrosis lung infection
2013-08-20
The bacterium Pseudomonas aeruginosa needs iron to establish and maintain a biofilm in the lungs of cystic fibrosis patients, and therapies have been proposed to deprive the bacteria of this necessary element. However, these techniques may not work, according to a new study published in mBio®, the online open-access journal of the American Society for Microbiology, because they only target one of the two types of iron that are available in the lung.
Current therapies focus on removing ferric iron [Fe(III)] but leave plenty of ferrous iron [Fe(II)] behind for the bacteria ...
Unemployment restricts access to kidney transplants, UNH research finds
2013-08-20
DURHAM, N.H. – People in end-stage kidney failure in need of a kidney transplant are much less likely to be placed on a waiting list for a new kidney or to actually receive a new kidney once on the list if they are unemployed or work part time, according to new collaborative research from the University of New Hampshire.
"There is a strong negative association between a patient's unemployment and the likelihood of being placed on a waiting list for a kidney transplant, and once on the waiting list, the likelihood of receiving a transplant," says Robert Woodward, the Forrest ...
Tiny fish make 'eyes' at their killer
2013-08-19
Small prey fish can grow a bigger 'eye' on their rear fins as a way of distracting predators and dramatically boosting their chances of survival, new scientific research has found.
Researchers from Australia's ARC Centre of Excellence for Coral Reef Studies (CoECRS) have made a world-first discovery that, when constantly threatened with being eaten, small damsel fish not only grow a larger false 'eye spot' near their tail – but also reduce the size of their real eyes.
The result is a fish that looks like it is heading in the opposite direction – potentially confusing ...
'Poisoning' corrosion brings stainless magnesium closer
2013-08-19
In a discovery that could have major implications for the aerospace, automotive and electronics industries, scientists have found a way to dramatically reduce the corrosion rate of lightweight wonder metal magnesium: adding arsenic.
Weighing in at two thirds less than aluminium, magnesium is the lightest structural metal. It has many potential industrial applications, but uptake is severely restricted by its poor resistance to corrosion. Identification of methods to restrict magnesium corrosion is the first step in engineering such technology into functional alloys.
For ...
Physician continuity after patients leave hospital for heart failure can help survival rates
2013-08-19
Patients with heart failure who see a physician in the first month after leaving hospital are more likely to survive than those who do not see a doctor, reports a new study in CMAJ (Canadian Medical Association Journal). The effect is slightly more pronounced in patients who see their regular physician rather than an unfamiliar physician.
In the United States and Canada, more than $20 billion is spent every year on patients who are readmitted to hospital within 30 days after discharge. Heart failure is one of the most common reasons for hospitalization and has a high ...
Altruism or manipulated helping? Altruism may have origins in manipulation
2013-08-19
Manipulation is often thought of as morally repugnant, but it might be responsible for the evolutionary origins of some helpful or altruistic behavior, according to a new study.
In evolutionary biology, manipulation occurs when an individual, the manipulator, alters the behavior of another individual in ways that is beneficial to the manipulator but may be detrimental to the manipulated individual. Manipulation not only occurs in humans and animals but also at the cellular level, such as among cells in a multicellular organism, or in parasites, which can alter the behavior ...
Far from being harmless, the effects of bullying last long into adulthood
2013-08-19
A new study shows that serious illness, struggling to hold down a regular job, and poor social relationships are just some of the adverse outcomes in adulthood faced by those exposed to bullying in childhood.
It has long been acknowledged that bullying at a young age presents a problem for schools, parents and public policy makers alike. Although children spend more time with their peers than their parents, there is relatively little published research on understanding the impact of these interactions on their lives beyond school.
The results of the new study, published ...
Droplet Digital™ PCR provides accurate quantification of next-generation sequencing libraries
2013-08-19
Seattle, WA – August 19, 2013 – A study published today found that Droplet Digital PCR (ddPCR™) can be used as an accurate and precise method for quality control of next-generation sequencing (NGS) libraries. NGS library QC is essential to optimizing sequencing data yield, thereby increasing efficiency and throughput while lowering cost. The research was published in the in the August issue of Biotechniques.
"While real-time PCR has traditionally been used to quantify libraries, we determined that the only truly accurate way to reproducibly quantify our NGS libraries ...
Large moths need to hear better
2013-08-19
Bats orient themselves through echolocation, and they find their prey by emitting calls and then process the echoes reflected back to them from the prey. Small insects reflect small echo signals, and large insects reflect large signals - simply because they are bigger. This makes it easier for bats to discover the large insects.
Large moths have to do something extra to avoid the bats, and their trick is to hear better. Their eardrums are larger and therefore more sensitive than ears of small moths, and this enables them to hear their enemies from at a greater distance. ...