Affiliation:
1. Memorial Sloan Kettering Cancer Center, Evelyn H. Lauder Breast Center, New York, NY
Abstract
Abstract
Objective
To assess breast imaging findings, biopsy rates, and malignancy rates in areas of palpable concern in women at high risk for breast cancer.
Methods
An IRB–approved retrospective review of a tertiary cancer center’s breast imaging database was performed. Breast imaging and electronic medical records of high-risk women with palpable findings detected on self- or clinical breast examination from January 1, 2010, to January 1, 2016, were reviewed. Descriptive statistical analyses were conducted.
Results
Imaging correlates for 322 palpable findings in 238 high-risk women included 55/203 (27.1%) on mammography, 183/302 (60.6%) on US, and 20/47 (42.6%) on MRI. Biopsies were performed for 104/322 (32.3%) palpable findings: 95/104 (91.3%) under imaging guidance and 9/104 (8.7%) under palpation after negative imaging. Of 322 palpable findings, 16 (5.0%) were malignant in 16/238 (6.7%) women, yielding a positive predictive value of biopsy of 16.8% (95% CI: 9.2%–24%). Women diagnosed with cancer had 16/16 (100%) sonographic, 9/14 (64.3%) mammographic, and 7/7 (100%) MRI correlates. Cancer histopathology included 12 invasive ductal carcinomas, 1 ductal carcinoma in situ, 1 invasive lobular carcinoma, 1 malignant phyllodes tumor, and 1 metastatic carcinoid tumor. Over two years of follow-up imaging in 183/238 (76.9%) women were reviewed; 7/183 (3.8%) were diagnosed with breast cancer at least one year after presenting with a palpable concern in a different location.
Conclusion
High-risk women with palpable findings exhibit a 6.7% malignancy rate, indicating the value of imaging workup in this population. In our cohort, imaging demonstrated a high negative predictive value.
Funder
Memorial Sloan Kettering Cancer Center Support Grant/Core
Publisher
Oxford University Press (OUP)
Subject
Radiology, Nuclear Medicine and imaging,Radiological and Ultrasound Technology
Cited by
4 articles.
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