Breast Implants Research Today is a free monthly online journal that collates and summarizes the latest research about Breast Implants, including details on silicone implant, breast augmentation, surgery, risks. | |||||||||
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Lesion and patient characteristics associated with malignancy after a probably benign finding on community practice mammography.Lehman CD, Rutter CM, Eby PR, White E, Buist DS, Taplin SH Department of Radiology, University of Washington Medical Center, Seattle Cancer Care Alliance, 825 Eastlake Ave. E, G2-600, PO Box 19023, Seattle, WA 98109-1023, USA. lehman@u.washington.edu OBJECTIVE: The purpose of this study was to identify patient and lesion characteristics associated with a diagnosis of breast malignancy within 3 years of having a probably benign finding (BI-RADS category 3) on a mammogram obtained in a community radiology practice. MATERIALS AND METHODS: The subjects were women 30 years old and older without breast implants or previous breast cancer who received notice of a probably benign finding on a bilateral screening mammogram between January 1, 1996, and June 30, 1999, in a community-based practice. From 82,898 mammograms, we identified 129 breast lesions designated probably benign that progressed to malignancy within 3 years of an index examination (cases) and matched them to 129 lesions designated probably benign that did not progress to malignancy within 3 years (controls). A breast imaging specialist blinded to case-control status interpreted all examinations and recorded detailed lesion descriptors according to the BI-RADS lexicon. RESULTS: Case lesions were more likely in patients who were older, postmenopausal, or had a strong family history of breast cancer or previous biopsy. The lesions were more likely masses with obscured, indistinct, or spiculated margins compared with control lesions (84.6% vs 66%, p = 0.03). Case lesions were more likely calcifications (29.5% vs 17.8%, p = 0.03). No cases were encountered among calcifications considered typically benign in the BI-RADS lexicon (vascular or coarse), and no controls were encountered among calcifications considered suspicious or highly suggestive of malignancy in the BI-RADS lexicon (amorphous, pleomorphic, branching, and fine linear) (p < 0.0001). CONCLUSION: In community practice, patient and lesion mammographic characteristics can be predictive of the likelihood of a subsequent cancer diagnosis of mammographic lesions designated as probably benign. Careful evaluation of mass margins and of the morphologic features of calcifications can help distinguish a malignant lesion from a probably benign finding. Published 23 January 2008 in AJR Am J Roentgenol, 190(2): 511-5.
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