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Breast Lesions Categorized as ‘Probably Benign’ Are Less Likely to Turn Cancerous

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Screening, diagnosing, and treating cancer has been a heated debate among the medical community. One argument states that patients are being over-screened, over-diagnosed and over-treated for the disease. And most recently, a newly conducted study offers supplemental evidence to this claim.

Published in the journal Radiology, a recent study found that abnormal breast tissue (lesions) referred as “probably benign” (non-cancerous) rarely turned out to be cancer tumors.

From the results of the study, its authors stipulate that less follow-up testings and exams may be the best way to go for women with such lesions; stating that in doing so, such a counter-action will significantly reduce patient anxiety and lower healthcare costs.

Lead researcher of the study and professor radiology at the Northeast Ohio Medical University in Youngstown, Ohio, Richard G. Barr, MD, PhD, and his team examined records from the American College of Radiology Imaging Network (ACRIN) trial 6666 in which women with dense breasts were subjected to mammography and ultrasound screenings.

Since dense breasts have more fibrous tissue than fat, imaging tests of dense breasts are often more difficult to read and interpret.

Ultrasound, an imaging technology that utilizes sound waves to produce pictures, is being employed more frequently along with mammography to detect tumors that aren’t detectable on mammograms.

For this study, the research team primarily focused on lesions visible on ultrasound and determined as “probably benign” or category 3 of the Breast Imaging-Reporting and Data System (BI-RADS 3).

The researchers then analyzed ultrasound exams and follow-up data of 2,662 participants registered between 2004 and 2006. A total of 519 women had 745 BI-RADS 3 lesions.

In follow-up screenings over a period of three-years, the study revealed that six (0.8 percent) of the 745 BI-RADS 3 lesions were in fact cancerous. Only two cancerous tumors were detected in follow-up screenings during the first year.

Present guidelines recommend that women with BI-RADS 3 lesions should have supplementary imaging studies at intervals of 6, 12, and 24 months to check for any suspicious change.

Barr also suggested that because of the low number of malignancies discovered among these lesions, yearly follow-up screenings of these lesions may be a suitable course of action.

Professor of radiology at Harvard Medical School and senior radiologist of the Breast Imaging Division at Massachusetts General Hospital, Daniel B. Kopans, MD, also found it significant to point out that the BI-RADS 3 lesions in the study, were detected by ultrasound and not mammography.

“ACRIN 6666 clearly showed that ultrasound can find some breast cancers that are not visible on screening mammograms. Since ACRIN 6666 was not a randomized trial it is not certain that finding these cancers will save lives,” said Kopans.


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