Follow-up intervals for breast imaging reporting and data system category 3 lesions on screening ultrasound in screening and tertiary referral centers

Sun Huh, Hee Jung Suh, Eun Kyung Kim, Min Jung Kim, Jung Hyun Yoon, Vivian Youngjean Park, Hee Jung Moon

Research output: Contribution to journalArticlepeer-review


Objective: To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast Imaging Reporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution. Materials and Methods: A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram, BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was 30.8 months (range, 6.8–52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathological characteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chisquare or Fisher’s exact test and continuous variables were compared using the independent t test or Mann-Whitney U test. Results: In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) were diagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers. In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, two were ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months and the remaining eight cancers newly developed after 13.1 months. Conclusion: One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US found in screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-up may be more appropriate.

Original languageEnglish
Pages (from-to)1027-1035
Number of pages9
JournalKorean journal of radiology
Issue number9
Publication statusPublished - 2020 Aug

Bibliographical note

Funding Information:
Received: October 8, 2019 Revised: March 10, 2020 Accepted: March 12, 2020 This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2017-0045). Corresponding author: Hee Jung Moon, MD, PhD, Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. • E-mail: This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright:
© 2020 The Korean Society of Radiology.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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