[US and dense breasts: where do we stand?]

Reducing Costs of Breast Examination: Ultrasound Performance and Inter-Observer Variability of Expert Radiologists Versus Residents

AIM

To compare efficiency levels between radiologist and radiology resident and any significant or clinically relevant differences in breast ultrasound diagnosis, thus reducing extra costs.

MATERIAL AND METHODS

100 patients attending for breast ultrasound were included. Each patient was examined by a radiologist, and subsequently by a resident of the radiology department. Both operators noted their findings and wrote a concluding report. Reports were compared for histological and biological analysis.

RESULTS

100 female patients with a mean age about 49 years were examined. The proportions of correct diagnoses of lesions individuated by radiologist and resident were 26.90 > 13.71% (p-value = 10.7), i.e. the radiologist was more accurate in comparison to resident in the individuation of breast lesions.

CONCLUSIONS

The radiologist was more accurate in comparison to radiology resident in the evaluation of breast pathology in ultrasonography diagnoses, and this could reduce cost and/or in-depth analysis.

Breast ultrasound diagnostic performance and outcomes for mass lesions using Breast Imaging Reporting and Data System category 0 mammogram

PURPOSE

To evaluate the outcomes and diagnostic performance of ultrasonography after a Breast Imaging Reporting and Data System (Bi-RADS) category 0 mammogram.

MATERIAL AND METHODS

This retrospective study reviewed 4,384 consecutive patients who underwent a screening mammography from January 2005 to July 2006; 391 of the 4,384 exams were classified as Bi-RADS category 0. After exclusions, 241 patients received subsequent sonogram. Ultrasonography was considered diagnostic when the Bi-RADS category was changed to 2, 4, or 5, and it was considered indeterminate (Bi-RADS 3) when the results indicated that the patients should return for a mammographic follow-up. The outcomes of these patients were assessed to evaluate the diagnostic performance of ultrasonography.

RESULTS

The mean age of the patients was 53.3 years (ranging from 35 to 81). Of the 241 patients, ultrasonography was considered diagnostic in 146 (60.6%) patients and indeterminate in 95 (39.4%) patients. In the diagnostic group, 111 out of 146 patients (70.2%) had a sonogram result of Bi-RADS category 2 after a 2-year follow-up without evidence of malignancy. Furthermore, 35 out of 146 patients (29.8%) had a suspicious sonogram with a result of Bi-RADS category 4. After a tissue sampling procedure, 10 patients were confirmed to have breast cancer, and 25 had benign histopathological features without any evidence of malignancy after a 2-year follow-up. The sensitivity of ultrasonography was 100%, specificity was 89.1%, and overall accuracy was 89.6%.

CONCLUSIONS

Based on the degree of resolution and its diagnostic performance, ultrasonography was determined to be an excellent method for the subsequent evaluation of Bi-RADS 0 mammograms.