The results address the concern that one harm of breast cancer screening is its high rate of biopsy of benign lesions, particularly those categorized as BI-RADS 4A and 4B (findings with low or intermediate chance of being malignant).
A team led by Dr. Margarita Zuley of the University of Pittsburgh included data from 57 women with 60 lesions classified as BI-RADS 4A or 4B who underwent ultrasound, stereotactic, or digital breast tomosynthesis-directed biopsy between April 2016 and November 2017; the women had contrast-enhanced digital mammography (CEDM) before the biopsy was performed.
After digital breast tomosynthesis and ultrasound and before CEDM, 72% of lesions were classified as BI-RADS 4. But after CEDM, 35% of these were reclassified as BI-RADS 3, thus eliminating the need for a biopsy, Zuley and colleagues found.
"CEDM use during diagnostic evaluation of BI-RADS 4A or 4B lesions may result in a significant increase in [positive predictive value] with minimal impact on cancer diagnosis rates," the group concluded.
