Ultrasound good enough for most teens with breast lumps

Breast ultrasound findings can obviate the need for excisional biopsy in most cases of teenage girls with breast lumps, according to recent research from Loyola University Health System.

In an article published in the Journal of Ultrasound in Medicine (April 2015, Vol. 34:4, pp. 617-625), Loyola researchers shared their research project that included 37 teenage girls with a total of 45 breast lumps. The study sought to determine whether the breast mass size at an initial ultrasound and growth at follow-up ultrasound could be used to determine if a lump could be managed conservatively or if a tissue biopsy was required.

The 37 girls were divided into three study groups. The first group (nine masses) received a follow-up ultrasound and a biopsy, while a second group (13 masses) only received a biopsy. The third group (23 masses) received a follow-up ultrasound without a biopsy. None of the lumps showed changes in appearance at follow-up ultrasound, and all the lumps that were biopsied were benign, according to the researchers.

In other analyses of lump dimension, volume, and volume change, the researchers concluded that biopsies could have been reduced in 89% of girls in the first study group and 96% in the third group if biopsies were only performed on breast masses with a largest dimension greater than 3 cm and a volume change per month greater than 16%.

Lead author Dr. Aruna Vade and colleagues recommend that excisional biopsy be performed only on solid breast masses that are sonographically suspicious for malignancy or breast masses that show progressive growth or are found in patients who have a known primary malignant tumor or family history of cancer.

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