Laila Samiian, MD reviewing Leung SE et al. AJR Am J Roentgenol 2016 Jul.

Ultrasound was better for evaluating interval breast lumps within 1 year after a negative mammogram.

American College of Radiology guidelines for evaluating interval palpable breast lumps in middle-aged and older women (age, ≥40) include diagnostic mammography, usually with additional ultrasound (J Am Coll Radiol 2013; 10:742). In a retrospective chart review that involved 612 women referred for interval lumps within 1 year of a negative mammogram, researchers in Canada assessed the value of repeat mammogram versus targeted ultrasound.

Repeat mammogram showed no change in the region of the lump in 87% of cases, and a mammographic change comprising a new mass or a previous lesion that became more prominent was noted in 13%. Ultrasound identified a lesion corresponding to the palpable lump in 50% of cases. Of these lesions, 75% were considered benign. In all, 80 lesions judged to be suspicious with ultrasound were biopsied; of these, 48 were malignant. Only three cases (all benign) demonstrated a mammographic change without an ultrasound correlate. Among palpable malignancies, 8% were mammographically occult.

CITATION(S):

Leung SE et al. New palpable breast lump with recent negative mammogram: Is repeat mammography necessary? AJR Am J Roentgenol 2016 Jul; 207:200. 

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