title: First ultrasound diagnosis of BI-RADS 3 lesions in young patients: Can 6-months follow-up be sufficient to assess stability?
abstract: OBJECTIVE
  To evaluate the outcome of repeated short-term follow-up with ultrasound in no high-risk young patients with a BI-RADS3 lesion at first examination.
  
  
  METHODS
  In this IRB-approved study 492 women, aged 18-34 years (mean±standard deviation, 28±4.5years) with first breast ultrasound examination in 2012-2014 were retrospectively evaluated. Inclusion criteria were: at least one BI-RADS3 lesion and (a) biopsy/surgical excision or (b) follow-up of at least 18 months (including a 6-month follow-up). BI-RADS category assigned during follow-up and pathologic findings in cases undergoing biopsy/surgical excision were collected. At the 6- and 18-month follow-up the recommended biopsy rates (RBR) and the corresponding positive predictive value (PPV) were calculated.
  
  
  RESULTS
  In 97 patients, 151 BI-RADS3 lesions were identified. Biopsy/surgical excision was initially performed in 25/151 (16.5%) lesions. After 6-month, category was downgraded to BI-RADS1/2 in 23/126 (15.3%) and upgraded to BI-RADS4 in 9/126 lesions (7.1%). Pathological diagnosis of these lesions was fibroadenoma in 5 and benign phyllodes tumor in 4 cases (RBR 7%, PPVbio44.4%). After 18-month one lesion was classified BI-RADS4 and pathological diagnosis was fibroadenoma (RBR 1.1%, PPVbio0%).
  
  
  CONCLUSIONS
  Our preliminary data show that follow-up imaging performed after 18 months from a first BI-RADS3 diagnosis does not affect clinical treatment and 6-month follow-up may be sufficient to assess the stability of probably benign lesions.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland. Electronic address: magda.marcon@usz.ch.
authors.forename: Magda
authors.initials: M
authors.lastname: Marcon
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland. Electronic address: thomas.frauenfelder@usz.ch.
authors.forename: Thomas
authors.initials: T
authors.lastname: Frauenfelder
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland. Electronic address: anton.becker@usz.ch.
authors.forename: Anton S
authors.initials: AS
authors.lastname: Becker
authors.affiliation: Department of Gynecology, University Hospital Zurich, Switzerland. Electronic address: Konstantin.dedes@usz.ch.
authors.forename: Konstantin J
authors.initials: KJ
authors.lastname: Dedes
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland. Electronic address: andreas.boss@usz.ch.
authors.forename: Andreas
authors.initials: A
authors.lastname: Boss
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D003557:Phyllodes Tumor / Q000000981:diagnostic imaging* / Q000473:pathology; D010808:Physical Examination; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult
keywords: BI-RADS 3; Benign breast lesion; Breast ultrasound; Follow-up; Young women