Purpose: Microcalcifications in the breasts can point to breast cancer. However, there is great morphologic variety, and microcalcifications do not always correlate with malignancy. We conducted a prospective study to compare ultrasound and mammography in the detection of microcalcifications following sonographic diagnosis of a hypoechoic focal lesion in women with dense breast composition. Materials and Methods: A total of 104 lesions potentially associated with microcalcifications (82 malignant and 23 benign lesions) were included in the study. The breast was examined by ultrasound (9?MHz, Aplio XG/500) with additional use of MicroPure imaging for the demonstration and evaluation of microcalcifications. The presence of a focal lesion was verified and microcalcifications were counted at ultrasound and mammography by blinded readers. The sensitivity and specificity were determined, and ROC analysis and AUC analysis were performed. Results: The women had a median age of 51 years. The average number of microcalcifications detected by sonography (2.12???2.77) and mammography (3.59???6.35) was not significantly different (p?>?0.05). Correlation of the techniques was adequate (Pearson?s r?=?0.616, p?0.0001; Spearman?s rho?=?0.654, p?0.0001). The intraclass correlation coefficient was K?=?0.382???0.072 (p?0.0001), also indicating adequate agreement of both techniques. The sensitivity and specificity were 70?%/30?% for MicroPure and 45?%/55?% for mammography. The positive predictive value of mammography was superior to that of MicroPure (88?% vs. 78?%). Conclusion: The sonographic detection of microcalcifications with MicroPure imaging in breasts with a hypoechoic focal lesion correlates well with digital mammography.
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