Role of second-look ultrasound examinations for MR-Detected lesions in patients with breast cancer

Purpose: To assess the clinical value of second-look ultrasound (US) examination for the evaluation of additional enhancing lesions detected on magnetic resonance (MR) imaging. Materials and Methods: Between May 2008 and February 2011, 794 consecutive patients with histologically confirmed breast cancer underwent breast MR imaging. We included 101 patients with 132 additional enhancing breast lesions detected on MR imaging who underwent second-look US.The imaging features and lesion category according to the Breast Imaging and Reporting and Data System (BI-RADS) were assessed with MR and US imaging, respectively. Results: According to the BI-RADS system, 67 lesions (50.8%) were classified as category 0, 33 lesions (25.0%) as category 3, and 32 lesions (24.2%) as category 4. Of the 67 indeterminate lesions on MR imaging, 34 (50.7%) were demonstrated on second-look US.11 of these 34 lesions showed suspicious sonographic features, including 1 lesion that showed malignancy (9.1%, 1/11). Most of the suspicious lesions on MR imaging (26 of 32 BI-RADS category 4 lesions, 81.3%) were demonstrated on second-look US, and 17 were malignant (65.4%, 17/26). Of the 6 BI-RADS category 4 lesions without sonographic correlation, 1 was malignant (16.7%, 1/6). Conclusion: Second-look US examination was useful for evaluating MR-detected lesions in patients with breast cancer.