Monday, November 28 | 1:30 p.m.-2:30 p.m. | M6-SSBR04-5 | E451A
Here, research findings will show that ultrasound may not be needed to help detect breast cancer in women with fatty breast density.Dr. Grace Lin from Kaiser Permanente in California will present her team's research, which explored whether diagnostic mammograms alone or the combination of mammography and ultrasound are better for examining women in this density category. For the study, researchers were blinded to the outcome and performed a retrospective review of the clinical history, diagnostic mammogram, and ultrasound exam in 2,066 women with 2,149 palpable lumps.
Out of these, 1,486 women (72%) had no mammographic correlate. The team detected a total of 136 cancers, with just one being found on ultrasound without a mammographic correlate. Lin and colleagues wrote that this means the cancer risk/negative predictive value/negative predictive value is 1/1,486 (0.07%) for using mammography alone in these patients.
Authors wrote that taking ultrasound out of the equation for women in the fatty breast category would yield benefits.
"Eliminating ultrasound from routine work-up of lumps in women with fatty breasts with no mammographic correlate would expedite care, increase access for other patients, and decrease healthcare costs," they wrote.
To see more results, please attend this Monday presentation.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
