Ultrasound BI-RADS might need some fine-tuning

Breast cancers missed by mammography could have been misclassified as benign lesions by ultrasound to begin with, according to a study presented at the American Institute of Ultrasound in Medicine meeting in Orlando in June.

Dr. Dona J. Hills and colleagues from the Queens-Long Island Medical Group in New York found that 41 cancers matched current BI-RADS 2 and 3 assignments, based on their original ultrasound descriptions. They also found that 23 of the 41 had benign or negative findings on mammography. Physicians should be suspicious about ultrasound-detected lesions with atypical features, which can cause false negatives in mammography as well, Hills said.

"If we exclude suspicious findings from the 'probably benign' category and put them into a BI-RADS 4, we might not be underestimating as many cancers as we had underestimated before," she said.