Breast ultrasound: recommendations for information to women and referring physicians by the European Society of Breast Imaging
Por:
Evans, A, Trimboli, R, Athanasiou, A, Balleyguier, C, Baltzer, P, Bick, U, Camps Herrero, J, Clauser, P, Colin, C, Cornford, E, Fallenberg, E, Fuchsjaeger, M, Gilbert, F, Helbich, T, Kinkel, K, Heywang-Koebrunner, S, Kuhl, C, Mann, R, Martincich, L, Panizza, P, Pediconi, F, Pijnappel, R, Pinker, K, Zackrisson, S, Forrai, G, Sardanelli, F, European Soc Breast Imaging EUSOBI and Europa Donna European Breast Canc
Publicada:
1 ago 2018
Categoría:
Radiology, nuclear medicine and imaging
Resumen:
This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious nipple discharge; recent nipple inversion; skin retraction; breast inflammation; abnormalities in the area of the surgical scar after breast conserving surgery or mastectomy; abnormalities in the presence of breast implants; screening high-risk women, especially when MRI is not performed; loco-regional staging of a known breast cancer, when MRI is not performed; guidance for percutaneous interventions (needle biopsy, pre-surgical localisation, fluid collection drainage); monitoring patients with breast cancer receiving neo-adjuvant therapy, when MRI is not performed. Possible indications such as supplemental screening after mammography for women aged 40-74 with dense breasts are also listed. Moreover, inappropriate indications include screening for breast cancer as a stand-alone alternative to mammography. The structure and organisation of the breast US report and of classification systems such as the BI-RADS and consequent management recommendations are illustrated. Information about additional or new US technologies (colour-Doppler, elastography, and automated whole breast US) is also provided. Finally, five frequently asked questions are answered.
Teaching Points
US is an established tool for suspected cancers at all ages and also the method of choice under 40.
For US-visible suspicious lesions, US-guided biopsy is preferred, even for palpable findings.
High-risk women can be screened with US, especially when MRI cannot be performed.
Supplemental US increases cancer detection but also false positives, biopsy rate and follow-up exams.
Breast US is inappropriate as a stand-alone screening method.
Filiaciones:
Evans, A:
Ninewells Hosp & Med Sch, Dundee Canc Ctr, Clin Res Ctr, Tom McDonald Ave, Dundee, Scotland
Trimboli, R:
Univ Milan, PhD Course Integrat Biomed Res, Dept Biomed Sci Hlth, Via Mangiagalli 31, I-20133 Milan, Italy
Athanasiou, A:
MITERA Hosp, Breast Imaging Dept, 6 Erithrou Stavrou Str, Athens 15123, Greece
Balleyguier, C:
Gustave Roussy Canc Campus, Dept Radiol, 114 Rue Edouard Vaillant, F-94800 Villejuif, France
Baltzer, P:
Med Univ Vienna, Div Mol & Gender Imaging, Dept Biomed Imaging & Image Guided Therapy, Wahringer Gurtel 18-20, A-1090 Vienna, Austria
Bick, U:
Charite, Clin Radiol, D-10117 Berlin, Germany
:
Univ Hosp La Ribera, Dept Radiol, Carretera Corbera,Km 1, Valencia 46600, Spain
Clauser, P:
Med Univ Vienna, Div Mol & Gender Imaging, Dept Biomed Imaging & Image Guided Therapy, Wahringer Gurtel 18-20, A-1090 Vienna, Austria
Colin, C:
Ctr Hosp Univ Femme Mere Enfant, Radiol Unit, Hosp Civils Lyon, 59 Blvd Pinel, F-69677 Bron, France
Cornford, E:
Cheltenham Gen Hosp, Thirlestaine Breast Ctr, Thirlestaine Rd, Cheltenham GL53 7AP, Glos, England
Fallenberg, E:
Charite, Clin Radiol, D-10117 Berlin, Germany
Fuchsjaeger, M:
Med Univ Graz, Dept Radiol, Div Gen Radiol, Auenbruggerpl 9, A-8036 Graz, Austria
Gilbert, F:
Univ Cambridge, Dept Radiol, Cambridge Biomed Campus,Hills Rd, Cambridge CB2 0QQ, England
Helbich, T:
Med Univ Vienna, Div Mol & Gender Imaging, Dept Biomed Imaging & Image Guided Therapy, Wahringer Gurtel 18-20, A-1090 Vienna, Austria
Kinkel, K:
Clin Grangettes, Inst Radiol, Chemin Grangettes 7, CH-1224 Geneva, Switzerland
Heywang-Koebrunner, S:
Referenzzentrum Mammog Munchen, Sonnenstr 29, D-80331 Munich, Germany
FFB gGmbH, Sonnenstr 29, D-80331 Munich, Germany
Kuhl, C:
Rhein Westfal TH, Univ Hosp Aachen, Pauwelsstr 30, D-52074 Aachen, Germany
Mann, R:
Radboud Univ Nijmegen, Med Ctr, Dept Radiol, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
Martincich, L:
IRCCS, Candiolo Canc Inst FPO, Unit Operat Radiodiagnost, Str Prov 142,Km 3-95, I-10060 Turin, Italy
Panizza, P:
Osped San Raffaele, Sci Inst, IRCCS, Breast Imaging Unit, Via Olgettina 60, I-20132 Milan, Italy
Pediconi, F:
Sapienza Univ, Dept Radiol Oncol & Pathol Sci, Viale Regina Elena 324, I-00161 Rome, Italy
Pijnappel, R:
Univ Med Ctr Utrecht, Dept Imaging, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands
Pinker, K:
Med Univ Vienna, Div Mol & Gender Imaging, Dept Biomed Imaging & Image Guided Therapy, Wahringer Gurtel 18-20, A-1090 Vienna, Austria
Mem Sloan Kettering Canc Ctr, Dept Radiol, Breast Imaging Serv, 300 E 66th St, New York, NY 10065 USA
Zackrisson, S:
Lund Univ, Skane Univ Hosp Malmo, Fac Med, Diagnost Radiol,Dept Translat Med, SE-20502 Malmo, Sweden
Forrai, G:
Duna Med Ctr, Dept Radiol, Budapest, Hungary
Sardanelli, F:
Univ Milan, Dept Biomed Sci Hlth, Via Morandi 30, I-20097 Milan, Italy
IRCCS, Policlin San Donato, Unit Radiol, Via Morandi 30, I-20097 Milan, Italy
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