Application of sonographic BI-RADS to synchronous breast nodules detected in patients with breast cancer.
OBJECTIVE
The purpose of this study was to evaluate the applicability of the current BI-RADS for sonography to the assessment of synchronous breast nodules other than the primary malignant tumor in patients with breast cancer.


METHODS
One hundred eighty-nine synchronous nodules in 147 breast cancer patients were surgically excised after localization, and 412 synchronous nodules in 191 patients were observed or biopsied or excised without localization. Among a total of 601 synchronous nodules, 372 nodules were ipsilateral and 229 were contralateral to a primary malignant tumor. Two radiologists retrospectively reviewed sonograms of these nodules and determined the sonographic BI-RADS category without clinical information or pathologic results. For each nodule, the preoperative BI-RADS category and pathologic or follow-up results were compared.


RESULTS
Four hundred eighty-two nodules were classified category 3; 112 nodules, category 4; and seven nodules, category 5. Fifty-five (11.4%) of the category 3 nodules and 57 (47.9%) of the category 4 and 5 nodules were confirmed malignant. Thirty-six (21.2%) of 170 category 3 synchronous nodules in the same quadrant as the primary tumor were confirmed malignant, as were 12 (9.8%) of 122 nodules in a different quadrant and eight (4.2%) of 190 nodules in the contralateral breast.


CONCLUSIONS
For assessment of synchronous nodules in breast cancer patients, application of conventional screening sonographic BI-RADS categories may not account for possible increased risk of malignancy in synchronous nodules, especially those in the same quadrant of the breast as the index malignant tumor.
Kim
Suk Jung
SJ
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-ku, Seoul 135-710, Korea.
Ko
Eun Young
EY
Shin
Jung Hee
JH
Kang
Seok Seon
SS
Mun
Sung Hee
SH
Han
Boo-Kyung
BK
Cho
Eun Yoon
EY
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods* / Q000592:standards*; D014481:United States