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Real-time breast ultrasound after the second opinion helps to discover new cancers and avoid unnecessary biopsies
In the current version of the clinical imaging report, the researchers noted that a real-time breast ultrasound examination after a second reinterpretation of the original study resulted in a change in clinical management of nearly 33% of patients and detection of other cancers in 5% of women.
The second review of the United States is common, said Dr. Elizabeth A. Morris of the Memorial Sloan Kettering Cancer Center in New York and colleagues, especially at the specialized tertiary health cancer center. In these cases, the expert will re-evaluate the diagnostic accuracy of the breast imaging examination, resolve the questions raised by the referral doctor and provide their clinical opinion on the case. The authors say that few treatments remain the same.
“Reassessing external research at the Integrated Cancer Center often leads to management changes,” wrote Morris, a radiologist and director of breast imaging services at Sloan Kettering. “However, although reassessment may reveal new cancers, the number of false positive lesions is expected to increase. The second review may result in cost, anxiety, and prolonged time between diagnosis and treatment.”
Part of the higher price tag may be because radiologists who provide a second opinion usually also recommend real-time ultrasound re-evaluation because they must use static images that are performed at different times and locations.
"The ultrasound image examined is a screenshot taken by a technologist or radiologist in the initial real-time ultrasound examination," Morris et al. Said that. With a new scan, radiologists can better describe any existing lesions and avoid misdiagnosis.
Morris's team conducted a retrospective study of 209 patients whose initial breast ultrasound study was sent to Sloan Kettering for a second opinion from January 2013 to May 2014. Within three months of receiving an external study in the hospital, these women underwent real-time breast examination ultrasound.
The authors say that the third review of these studies seems to have had a considerable impact. Real-time ultrasound after the second opinion resulted in a change in management of 32.5% of patients, while doctors found additional cancer in 5.3% of the time. Additional biopsy was performed in approximately one-fifth of the cases - one in four cases tested positive for cancer - but increased ultrasound allows one-sixth of patients to avoid unnecessary pre-arranged living tissue an examination.
Morris and her colleagues said that the third review helped to alleviate the differences in BI-RADS, and many doctors objected to the content. It provides an extra layer of protection for the patient.
“Real-time breast ultrasound has been identified as an important tool for patient management in our comprehensive cancer center,” the authors write. “Although other false positive lesions can be found in real-time breast ultrasound testing, a large number of patients will help to find other cancers or avoid unnecessary biopsies.”