Evidence map›Paper›PMID 33462625›Full record

ArticleEuropean radiology2021

Nonpalpable breast lesions: impact of a second-opinion review at a breast unit on BI-RADS classification.

Constance de Margerie-Mellon, Jean-Baptiste Debry, Axelle Dupont, Caroline Cuvier, Sylvie Giacchetti, Luis Teixeira, Marc Espié, Cédric de Bazelaire

Abstract read
PubMed Publisher
In one paragraph

Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Constance de Margerie-Mellon *Department of Radiology, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France. constance.de-margerie@aphp.fr.ORCID http://orcid.org/0000-0001-9359-7077
Jean-Baptiste Debry *Department of Radiology, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France.
Axelle DupontDepartment of Biostatistics, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.
Caroline CuvierBreast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.
Sylvie GiacchettiBreast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.
Luis TeixeiraBreast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.
Marc EspiéBreast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.
Cédric de BazelaireDepartment of Radiology, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France.
Université Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare BI-RADS classification, management, and outcome of nonpalpable breast lesions assessed both by community practices and by a multidisciplinary tumor board (MTB) at a breast unit.

methodsAll nonpalpable lesions that were first assigned a BI-RADS score by community practices and then reassessed by an MTB at a single breast unit from 2009 to 2017 were retrospectively reviewed. Inter-review agreement was assessed with Cohen's kappa statistic. Changes in biopsy recommendation were calculated. The percentage of additional tumor lesions detected by the MTB was obtained. The sensitivity, AUC, and cancer rates for BI-RADS category 3, 4, and 5 lesions were computed for both reviews.

resultsA total of 1909 nonpalpable lesions in 1732 patients were included. For BI-RADS scores in the whole cohort, a fair agreement was found (κ = 0.40 [0.36-0.45]) between the two reviews. Agreement was higher when considering only mammography combined with ultrasound (κ = 0.53 [0.44-0.62]), masses (κ = 0.50 [0.44-0.56]), and architectural distortion (κ = 0.44 [0.11-0.78]). Changes in biopsy recommendation occurred in 589 cases (31%). Ninety of 345 additional biopsies revealed high-risk or malignant lesions. Overall, the MTB identified 27% additional high-risk and malignant lesions compared to community practices. The BI-RADS classification AUCs for detecting malignant lesions were 0.66 (0.63-0.69) for community practices and 0.76 (0.75-0.78) for the MTB (p < 0.001).

conclusionAgreement between community practices and MTB reviews for BI-RADS classification in nonpalpable lesions is only fair. MTB review improves diagnostic performances of breast imaging and patient management. KEY POINTS: • The inter-review agreement for BI-RADS classification between community practices and the multidisciplinary board was only fair (κ = 0.40). • Disagreements resulted in changes of biopsy recommendation in 31% of the lesions. • The multidisciplinary board identified 27% additional high-risk and malignant lesions compared to community practices.

Indexed as

Breast NeoplasmsMammographyBreastFemaleHumansObserver VariationRetrospective StudiesUltrasonography, MammaryBreast neoplasmsMagnetic resonance imagingMammographyObserver variationUltrasonography

Identifiers

PMID33462625
OpenAlexW3122515627

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.