Whole-breast US imaging: four-year follow-up.

Abstract

Between March 1980 and April 1981, 1,140 women underwent physical examination, xeromammography, and whole-breast ultrasound (US) using a whole-breast water path system. Results of each study were interpreted independently by separate observers in a blind fashion. Biopsy revealed 125 cancers in 127 breasts. Findings were considered to be suspicious for carcinoma in 199 women based on physical examination, in 201 based on mammograms, and in 255 based on US scans. Physical examinations were able to reveal 91% (115/127) of the cancers, reflecting the referral nature of the population, and failed to detect 12 lesions. Mammograms disclosed 94% (119/127) of the cancers, including 12 clinically occult lesions, but did not show eight palpable cancers. US scans disclosed only 64% (81/127) of the cancers, all of which were palpable. In a 4-year follow-up, no cancers have appeared in the group that had suspicious findings by US only. We conclude that US should not be used routinely to screen women for breast cancer.

Role of ultrasonography in detecting mammographically occult breast carcinoma in women with dense breasts

“…On the other hand, additional cancers detected by ultrasonography in women over age 50 were seven, compared with 112 detected at mammography, thus accounting for a relative sensitivity increase of 6.2%. Overall, the present experience confirms the possibility of ultrasonography detecting mammographically occult cancer in dense breasts [1,18] although we agree with Kopans [19][20][21][22] that this does not constitute sufficient evidence to support the introduction of this policy in current screening practice. However, the observed cancer detection rate at ultrasonography is promising as to final results of ongoing prospective studies.…”

Ultrasonographic Discrimination of Benign and Malignant Breast Lumps with Histopathological Correlation

“…So, there is a great need for development of additional reliable methods to complement the existing diagnostic procedures to avoid unnecessary biopsy. The initial screening studies 7,8 with sonography in the 1980s were not as successful as the present study. A decade later favorable results for sonography of palpable breast masses were also noted in more studies.…”

Sonography of palpable breast cancer

“…Sickles et al 11 found that sonography missed 11 of 41 palpable malignancies, whereas mammography missed only 1. Kopans et al 12 had similar results: sonography did not visualize 34 of the 127 palpable cancers, whereas mammography missed only 8 of them. A decade later, however, Gordon et al 13 noted 58 mammographically occult cancers detected by sonography, of which 43 (74%) were palpable.…”