Ultrasonography of Breast Lesions Detected in Mammography Screening

Abstract

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.

Ultrasound-guided lumpectomy of nonpalpable breast cancers: A feasibility study looking at the accuracy of obtained margins

“…Excision of these malignancies after wire localization is cumbersome and often ends with disappointing results because the resection margins are frequently positive for tumor invasion [6]. Although not all mammographically detected, nonpalpable breast cancers are visualized with US, it can accurately delineate these small lesions in 50-60% of cases [7,8]. We report on our early experience with excision of nonpalpable breast cancers, using intraoperative US guidance, as an alternative technique for excision after wire localization, paying particular attention to margin clearance.…”

The Additional Value of us to Mammography in the Diagnosis of Breast Cancer

“…Studies comparing the accuracy of mammography and US in patients with palpable malignancies have reported comparable diagnostic performance of the two imaging modalities, with a sensitivity of US in the range of 81 to 97% (3, 9,17). The detection and characterization of small carcinomas on US is more difficult, the reported sensitivity of nonpalpable malignant tumors being in the range of 45 to 61% depending on the criteria used for a positive US diagnosis (3, 8,10).…”

Ultrasonography of invasive lobular breast carcinoma

“…According to our results, it would seem that insidiously growing lobular carcinoma may have a correspondingly unimpressive, but noticeable, appearance at US. As distortion is not acknowledged as one of the characteristic US features of breast cancer (3, 4, 6,10,16,22,23), it was classified as an indeterminate finding in our analysis.…”