Retroareolar Intraductal Lesions Detected by Screening Ultrasound in Dense Breasts: Malignancy Rate and Predictive Imaging Features.
Vascularity on Doppler ultrasound strongly linked to malignancy in retroareolar intraductal lesions
Retroareolar Intraductal Lesions Detected by Screening Ultrasound in Dense Breasts: Malignancy Rate and Predictive Imaging Features.
The clinical significance of intraductal lesions detected as primary findings on screening breast ultrasound (ultrasound) remains unclear.
This study aimed to determine the malignancy rate of retroareolar intraductal lesions detected by supplemental screening breast ultrasound in asymptomatic women with mammographically dense breasts and to identify imaging features associated with malignancy.
This multicenter retrospective study included asymptomatic women with dense breasts who had intraductal lesions located in the retroareolar area detected on screening breast ultrasound between January 2012 and December 2021.
vascularity on doppler strongly raises odds of malignancy
Among 550 intraductal lesions in 544 women (mean age ± standard deviation, 49.8 ± 9.3 years), 529 (96.2%) were benign, and 21 (3.8%) were malignant.
The beyond-the-duct appearance on ultrasound demonstrated a sensitivity of 14.3% (3 of 21) and a high specificity of 99.1% (524 of 529).
The presence of vascularity on color Doppler ultrasound demonstrated a sensitivity of 95.2% (20 of 21) and a low specificity of 41.2% (218 of 529).
Interreader agreement for sonographic features ranged from marginal to excellent (lower bounds of the 95% CI for Fleiss' kappa, 0.39-0.89).
Retroareolar intraductal lesions detected on screening ultrasound in women with dense breasts exhibited a low malignancy rate of 3.8%.
A beyond-the-duct appearance and the presence of vascularity on color Doppler ultrasound were independently associated with malignancy in retroareolar intraductal lesions detected on screening breast ultrasound.