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Breast Lesions in Young Women Usually Benign, Diagnosed by Ultrasound: Presented at RSNA By Ed Susman CHICAGO -- December 3, 2009 -- Although lumps or other abnormalities are frequently found in the breasts of women under 30 years of age, almost all of the lesions are benign, and ultrasound imaging can identify those lesions that are of concern, said researchers at the Radiological Society of North America (RSNA) 95th Annual Meeting. In a presentation on December 2, Constance Lehman, MD, PhD, University of Washington, Seattle, Washington, said, “We found no malignancy in any patient with negative, benign, or probably benign ultrasound finding.” All 1,091 lesions in 830 women were graded using the Breast Imaging-Reporting and Data System (BI-RADS), and all the lesions rated BI-RADS 1-3 turned out to be benign. Of the lesions graded BI-RADS 4 or BI-RADS 5 -- suspicious or highly suspicious lesions -- doctors found 3 malignancies in the group of women who were under 30 years of age. “Ultrasound is highly sensitive in this setting [100%], supporting its use as the primary imaging modality,” Dr. Lehman said. The overall incidence of cancer in the women under 30 was 0.4%, she said at a press briefing. Ultrasound analyses determined that 526 patients had BI-RADS 1 or BI-RADS 2 lesions -- abnormalities that were unlikely to be cancer; another 140 patients were classified as BI-RADS 3; and 164 patients (20% of the total) were graded as having BI-RADS 4 or BI-RADS 5 lesions. Of those 164 lesions, Dr. Lehman said 3 were cancerous, for a yield of 1.8%. She said that 46 of the women with a BI-RADS 3 report underwent biopsy -- all of which came back negative. Outcomes were based on biopsy, if it was performed, for the absence of cancer at 2 years post imaging. The researchers also checked regional tumour registries to make sure that women who had developed cancer had not escaped surveillance if they had changed providers. “Many women of this age have ‘lumpy’ breasts, which is different than a ‘lump’ in the breast. Dr. Lehman’s study shows that we can be comfortable in starting out diagnostic work-up with ultrasound in these women,” said Joseph Tashjian, MD, St. Paul Radiology, St. Paul, Minnesota, who moderated the press briefing. “We have had the same experience as Dr. Lehman with ultrasound. We find it very reliably answers the question as to whether the lesion is cancer or normal breast tissue.” [Presentation title: Outcomes of Targeted Ultrasound Evaluation in Women Under 30 Years of Age With Focal Breast Signs or Symptoms] E-mail this page to a friend or colleague! To print, use this version