Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Breast ultrasound : recommendations for information to women and referring physicians by the European Society of Breast Imaging

Evans, Andrew ; Trimboli, Rubina M. ; Athanasiou, Alexandra ; Balleyguier, Corinne ; Baltzer, Pascal A. ; Bick, Ulrich ; Camps Herrero, Julia ; Clauser, Paola ; Colin, Catherine and Cornford, Eleanor , et al. (2018) In Insights into Imaging 9(4). p.449-461
Abstract

Abstract: 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... (More)

Abstract: 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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Automated whole breast ultrasound, BI-RADS, Breast cancer, Breast ultrasound (US), Colour-Doppler, Elastography
in
Insights into Imaging
volume
9
issue
4
pages
13 pages
publisher
Springer
external identifiers
  • scopus:85052322508
  • pmid:30094592
ISSN
1869-4101
DOI
10.1007/s13244-018-0636-z
language
English
LU publication?
yes
id
04be8928-d76d-46f6-9d03-25df9ae14fb3
date added to LUP
2018-09-27 08:21:45
date last changed
2021-10-06 04:13:17
@article{04be8928-d76d-46f6-9d03-25df9ae14fb3,
  abstract     = {<p>Abstract: 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.</p>},
  author       = {Evans, Andrew and Trimboli, Rubina M. and Athanasiou, Alexandra and Balleyguier, Corinne and Baltzer, Pascal A. and Bick, Ulrich and Camps Herrero, Julia and Clauser, Paola and Colin, Catherine and Cornford, Eleanor and Fallenberg, Eva M. and Fuchsjaeger, Michael H. and Gilbert, Fiona J. and Helbich, Thomas H. and Kinkel, Karen and Heywang-Köbrunner, Sylvia H. and Kuhl, Christiane K. and Mann, Ritse M. and Martincich, Laura and Panizza, Pietro and Pediconi, Federica and Pijnappel, Ruud M. and Pinker, Katja and Zackrisson, Sophia and Forrai, Gabor and Sardanelli, Francesco},
  issn         = {1869-4101},
  language     = {eng},
  month        = {08},
  number       = {4},
  pages        = {449--461},
  publisher    = {Springer},
  series       = {Insights into Imaging},
  title        = {Breast ultrasound : recommendations for information to women and referring physicians by the European Society of Breast Imaging},
  url          = {http://dx.doi.org/10.1007/s13244-018-0636-z},
  doi          = {10.1007/s13244-018-0636-z},
  volume       = {9},
  year         = {2018},
}