Palpable breast masses: evaluation by high frequency, hand-held real-time sonography and xeromammography. Work in progress.

Fleischer, Adiel; Muhletaler, Carlos A.; Reynolds, Vernon; Machin, J E; Thieme, Gary A.; Bundy, A L; Winfield, Alan C.; James, A. Everette

doi:10.1148/radiology.148.3.6878706

Cited by 31 publications

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“…1 -9 Others have presented data correlating XRM and HSM. 10 ·u A comparison between HSM and ASM has also been reported. u,u Although our study 13 in which all patients had XRM, that evaluation only compared the two types of ultrasound examinations.…”

Section: Discussionmentioning

confidence: 99%

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Hand-held and automated sonomammography. Clinical role relative to X-ray mammography.

Vilaro

Kurtz²,

Needleman³

et al. 1989

Journal of Ultrasound in Medicine

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A retrospective analysis of 73 patients who had undergone X-ray mammography (XRM), automated senemammography (ASM), and hand-held sonomammography (HSM) was performed to evaluate the clinical role of both types of sonomammography (SM) relative to XRM. The results were classified on the basis of mammographic and sonographic findings. Clinical and/or surgical proof was obtained in all 73 patients. The SM was com-A lthough X-ray mammography (XRM) is the imaging modality of choice for the detection of breast carcinoma, sonomammography (SM) has an important role in further characterizing breast abnormalities detected either by physical exam, XRM, or both. It is of particular value in characterizing palpable masses in women with radiographically dense breast tissue.•-• Different series have compared XRM to automated sonomammography (ASM), 1 " 9 hand-held realtime sonomammography (HSM) to XRM, 10 ·u and HSM to ASM.12. 13 There is no report, however, of a comparative study in which all three modalities were used in plementary to XRM, depending on the radiographic breast density. When comparison was made between ASM (4.5 MHz) and the HSM (7.5 MHz), the pathologic condition was better identified by HSM in 86% of the cases. Moreover, in no cases was ASM better than HSM. KEY WORDS: breast masses, sonomammograph~ x-ray mammography. (J Ultrasound Med 8:95, 1989) every patient and in which the clinical value of each was assessed. According!~ we studied 150 patients in which all three modalities were performed. Seventy-three of these had clinical and/or surgical proven diagnoses, and it is this group that constitutes this study. MATERIALS AND METHODSThe group of patients consisted of 73 women between 22 and 84 years old (mean 39 years of age) who were evaluated between January and December 1985. All patients had a recent mammogram prior to the ultrasound examination. In 88% of the cases, the interval between Received January 22, 1988, from the •Division of Diagnostic: Ultra~ sound (Department of Radiology) and the §Department of Surgery. the XRM and the SM studies was less than or equal to 6 Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; weeks. In the other 12o/o, the interval was between three and the ~epartment of Radiology (Ultrasound Section), Vanderbilt to 8 months. The mammographic findings were known University Hospital, Vanderbilt, Tennessee. Revised manuscript accepted for publication on June 6, 1988. at the time of the sonographic studies as were any pertifCurrent affiliation: cr Radiology Complex, Bayamon, Puerto Rico. nent findings from the clinical examination.

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Section: Discussionmentioning

confidence: 99%

“…•-• Different series have compared XRM to automated sonomammography (ASM), 1 " 9 hand-held realtime sonomammography (HSM) to XRM, 10 ·u and HSM to ASM.12. 13 There is no report, however, of a comparative study in which all three modalities were used in plementary to XRM, depending on the radiographic breast density.…”

mentioning

confidence: 99%

Hand-held and automated sonomammography. Clinical role relative to X-ray mammography.

Vilaro

Kurtz²,

Needleman³

et al. 1989

Journal of Ultrasound in Medicine

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“…Moreover, the follow-up period has usually been 12 months or less (Wolfe et al, 1987;Robertson, 1993), and the proportion of patients lost to follow-up has not been well defined in many of the studies (Baines et al, 1986;Bird, 1989;Sienko et al, 1993). For these reasons, the actual sensitivity and specificity of breast imaging in the detection of breast cancer will be lower than reported.The value of ultrasound examination of the breast as an adjunct to mammography, in the work-up of symptomatic breast disease is well established (Fleischer et al, 1983;Bassett et al, 1987;Warwick et al, 1988;Jackson, 1995). No prospective series with well-specified follow-up have been published in which both modalities are used as an integrated approach to determine the sensitivity and specificity in symptomatic patients.…”

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confidence: 99%

“…The value of ultrasound examination of the breast as an adjunct to mammography, in the work-up of symptomatic breast disease is well established (Fleischer et al, 1983;Bassett et al, 1987;Warwick et al, 1988;Jackson, 1995). No prospective series with well-specified follow-up have been published in which both modalities are used as an integrated approach to determine the sensitivity and specificity in symptomatic patients.…”

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Sensitivity, specificity and predictive values of breast imaging in the detection of cancer

Duijm

Guit²,

Zaat³

et al. 1997

Br J Cancer

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Summary In an observational follow-up study we determined whether the combined use of mammography and breast ultrasonography is an appropriate diagnostic tool to select patients with symptomatic breast disease who need additional pathological evaluation. Mammography and ultrasound were used as complementary diagnostic modalities in 3014 consecutively referred and mainly symptomatic patients. Sensitivity, specificity, predictive values and likelihood ratios were calculated according to standard procedures. Virtually complete follow-up was obtained by correlating the radiological diagnosis with clinical records, final pathological findings, records from the Cancer Register and data from questionnaires sent to the general practitioners of all the referred patients. After an average follow-up period of 30 months, the sensitivity for breast cancer detection was 92.0% and the specificity 97.7%. A positive predictive value of 68.0%, a negative predictive value of 99.6%, a positive likelihood ratio of 40 and a negative likelihood ratio of 0.08 were found. The mean diagnostic delay as a result of false negative examinations was 9 months (range 0-20 months). We conclude that breast imaging in routine daily practice, consisting of the integral use of mammography and ultrasonography, is an appropriate tool in the detection of cancer and should be included in the work-up of symptomatic breast disease.Keywords: breast neoplasm; mammography; ultrasonography; sensitivity; specificity In many Western countries breast cancer is the most common cause of death in women aged 35-55. The sensitivity and specificity of mammography in the detection of breast cancer have been reported in several screening studies (Tabar et al, 1984;Baines et al, 1986;Bird, 1989;Sickles et al, 1990;Robertson, 1993) and diagnostic (consultative) studies (Wolfe et al, 1987;Hansell et al, 1988;Reintgen et al, 1993;Robertson, 1993;Sienko et al, 1993). However, in diagnostic studies, these parameters have frequently been determined retrospectively in pathologically proven breast cancers (Hansell et al, 1988;Reintgen et al, 1993). Moreover, the follow-up period has usually been 12 months or less (Wolfe et al, 1987;Robertson, 1993), and the proportion of patients lost to follow-up has not been well defined in many of the studies (Baines et al, 1986;Bird, 1989;Sienko et al, 1993). For these reasons, the actual sensitivity and specificity of breast imaging in the detection of breast cancer will be lower than reported.The value of ultrasound examination of the breast as an adjunct to mammography, in the work-up of symptomatic breast disease is well established (Fleischer et al, 1983;Bassett et al, 1987;Warwick et al, 1988;Jackson, 1995). No prospective series with well-specified follow-up have been published in which both modalities are used as an integrated approach to determine the sensitivity and specificity in symptomatic patients.To overcome the restrictions mentioned, we performed a prospective study with extensive follow-up of over 3000 consecutive

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“…Breast cancers so examined have, however, often been large and/ or palpable (4,6,8). Many small, non-palpable breast cancers are detected at mammography screening (1,14,18).…”

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Ultrasonography of Breast Lesions Detected in Mammography Screening

Pamilo¹,

Soiva²,

Anttinen³

et al. 1991

Acta Radiol

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Mammography screening was carried out in 18012 women (aged 50-59) of whom 579 (3.21%) had to be recalled for clinical mammography. After completion of the clinical mammography each woman also had ultrasonography (US) with a hand-held real-time apparatus using a 7.5 MHz probe. There were 79 verified breast cancers; 32 of these were palpable and were also depicted at US, but only 29 (61.7%) of non-palpable breast cancers (n=47) were found at US. Twenty-two of the non-palpable breast cancers were seen at US as a tumor-like lesion, 2 because of local echo-architecture distortion, and 5 only because of acoustic shadowing. The US image did not help to differentiate between malignant and benign lesions.

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Palpable breast masses: evaluation by high frequency, hand-held real-time sonography and xeromammography. Work in progress.

Cited by 31 publications

References 0 publications

Hand-held and automated sonomammography. Clinical role relative to X-ray mammography.

Hand-held and automated sonomammography. Clinical role relative to X-ray mammography.

Sensitivity, specificity and predictive values of breast imaging in the detection of cancer

Ultrasonography of Breast Lesions Detected in Mammography Screening

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