Sonography of palpable breast cancer

Abstract

Purpose Because of the increasing use of sonography to rule out cancer in women with palpable breast abnormalities, this study was performed to determine the rate of sonographically occult malignancy in this clinical setting. Methods Women who were recommended for biopsy based on mammographic and/or clinical findings underwent breast sonography. This study retrospectively analyzed the subset of patients with palpable malignant lesions. Lesions were classified as visible or occult on mammography and sonography. Patients without a tissue diagnosis of tumor were excluded. Results Of 1,346 masses that underwent biopsy or aspiration, 616 lesions were palpable, and of these, 293 were malignant. Sonography detected all 293 palpable malignant lesions (95% confidence interval for sensitivity, 99–100%). Eighteen lesions were mammographically occult. The median lesion size as determined by sonography was 1.8 cm; for the lesions that were mammographically occult, the median size was 1.6 cm. The most common histopathologic diagnosis for both groups of lesions was infiltrating ductal carcinoma. Conclusions All palpable malignant breast lesions were visible by sonography in patients in whom a biopsy was recommended. However, we caution that until the false‐negative rate of sonography for equivocal palpable abnormalities is determined prospectively, sonography cannot be accurately applied to rule out malignancy in this setting. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:211–216, 2000.

Negative Predictive Value of Sonography and Mammography in Patients with Focal Breast Pain

“…Moreover, the ability to differentiate benign and malignant features of solid masses using ultrasound has improved (12). Several studies have shown the utility of sonography in detecting palpable breast cancer that is obscured by mammographically dense breast tissue, with sensitivities ranging from 94.2% to 100% (13,14). With the evolving role of sonography, it is important to determine its role as an adjunct to mammography in focal breast pain.…”

Optimising surgical accuracy in palpable breast cancer with intra-operative breast ultrasound – Feasibility and surgeons’ learning curve

“…Moreover, unexpected additional intraductal disease can often not be detected by US. [10,[23][24][25] M A N U S C R I P T…”

ACR Appropriateness Criteria® on Palpable Breast Masses

“…With the development of 7.5-MHz to 10-MHz linear-array transducers with excellent nearfield resolution, the role of ultrasound has expanded to include the characterization of the shape, margins, and internal matrix of masses and guidance for needle localization, aspiration, and biopsy. Ultrasound is also highly accurate in identifying palpable malignant breast masses, although no single examination alone should be used to exclude malignancy [8].…”

“…In one study comparing physical examinations, mammography, and ultrasound, the authors concluded that for palpable masses, physical examination and ultrasound formed the optimal preoperative test combination [8]. Mammography was also necessary to detect occult cancer in the contralateral or ipsilateral breast.…”