Ipsilateral BI-RADS 3 lesions on preoperative ultrasound harbor higher-than-expected malignancy risk in breast cancer patients

In women with newly diagnosed breast cancer, additional ipsilateral BI-RADS 3 lesions on ultrasound had a malignancy rate of 7.5% (41/544), vs 0.9% (13/1451) for contralateral lesions. Same-quadrant location, architectural distortion, and calcifications predicted malignancy.

• At patient level, malignancy was identified in 3.5% (51/1458) overall, with ipsilateral lesions showing 9.8% (39/397) vs 1.1% (12/1061) for contralateral (p<0.001).
• Independent predictors for ipsilateral malignancy: same-quadrant location (OR 4.3, 95%CI 1.9-9.7), architectural distortion on US (OR 8.5, 1.6-46.1), mammographic suspicious calcifications (OR 2.9, 1.4-6.0).

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