Pathologic assessment of non-palpable probably benign breast masses at sonography: Can instant intervention be avoided and is follow-up adequate?

Abstract

Aim of the study: To evaluate the pathologic results, determine the negative predictive value of non-palpable probably benign lesions at ultrasound and asses whether follow-up is adequate and immediate biopsy can be avoided. Materials and methods: Four hundred and eight cases which were referred to our breast imaging unit between 2004 and 2008 for biopsy evaluation were enrolled into the study. Two hundred and thirteen probably benign solid masses are classified as BI-RADS 3 in 205 of the enrollees. All masses were sonographically detectable and were classified through the guidelines of BI-RADS lexicon for sonography before the final pathological examination. All pathologic results were evaluated and the negative predictive value, false negativity rate and 95% confidence interval were calculated. Results: Of the 213 masses, fine needle aspiration cytology was performed in 120. US-guided wire localization and eventual surgery were carried out in the remaining 93 masses. Finally, 211 of the punctured lesions turned out to be benign and only two malignant lesions were detected. The resulting negative predictive value was found to be 99.1% while the false negative rate value was 0.9%. Conclusion:With the results provided, we think that in the patients with sonographically detected probably benign breast lesions, short term follow-up seems to be a strong alternative to immediate biopsy with its reliable high negative predictivity as well as low false negativity.