Abstract
Purpose
To determine if real-time breast ultrasound (RTUR) after second opinion reinterpretation
of submitted static ultrasound images at a comprehensive cancer center impacts clinical
management, specifically by detecting additional cancer and preventing unnecessary
biopsy.
Materials and methods
In this IRB-approved and HIPAA-compliant retrospective study, 209 patients were included
who had breast ultrasound studies from outside facilities submitted for second opinion
review between January 2013 and May 2014, and who subsequently underwent RTUR at our
institution within three months of the outside study. Findings on submitted exams
were compared with those on RTUR and disagreements between them were annotated to
indicate the presence or absence of suspicious lesions and recommendation for biopsy.
Changes in management were defined as any additional biopsies performed or biopsies
averted after RTUR and reported as frequencies and percentages using 95% confidence
intervals.
Results
Following RTUR, 49 additional biopsies were performed in 43/209 patients (20.6%; 95%
CI 15.1–26.1%). Additional cancer was found in 12/49 (24.5%) biopsies in 11/209 patients
(5.3%; 95% CI 2.2–8.2%). Forty biopsies in 31/209 (14.8%; CI 10.0–19.7%) patients
originally recommended were canceled after RTUR. Overall, a change in management after
RTUR was observed in 68/209 patients (32.5%; 95% CI 26.1–38.9%), including patients
with either additional biopsies performed or biopsies averted.
Conclusion
RTUR was found to be an important tool in the management of patients at our comprehensive
cancer center. Although additional false-positive lesions may be detected on RTUR,
a great number of patients will benefit from RTUR in finding additional cancers or
avoiding unnecessary biopsies.
Abbreviations:
MRI (magnetic resonance imaging), PACS (Picture Archiving and Communication System), RTUR (real-time ultrasound re-evaluation), US (ultrasound)Keywords
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Article info
Publication history
Published online: June 27, 2018
Accepted:
June 14,
2018
Received in revised form:
June 1,
2018
Received:
February 5,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
