WS18: Breast
WS18‐01Ultrasounds of the breast – the role of the gynecologist

Abstract

Early detection of breast cancer is of paramount importance for its management. Therefore, new diagnostic tools are continously searched, including 3D‐US and 3D Power Doppler, and for later management, the study of the sentinel node. 3D ultrasonography (3‐D US) may be of value in the differential diagnosis of the following conditions. Cysts Not all cysts display a typical US appearance. Small cysts may lack the distal sound enhancement. Inflammatory cysts may exhibit a thickened wall. However, the major problem it the not so rare presence of intracystic echoes, which may be either real or artifactual. Fibroadenomas A refraction artifact (edge shadowing) is often noted at each lateral margin of smooth‐marginated fibroadenomas. Contours are irregular in about 25% of cases, and in about 5% shadowing makes it impossible to rule out malignancy. Carcinomas Shadowing is associated only with those carcinomas that have a significant amount of fibrosis (< 50% of cases in our experience). Some partial shadowing seen with some carcinomas may also be caused by beam scattering by jagged margins, with 3D scan potentially useful for diagnosis. The sentinel node. Axillary lymph node status is the most important pathological determinant of prognosis in early breast cancer, whereas local axillary lynphadenectomy is the most reliable staging procedure. However, routine axillary dissection does not benefit the majority of patients with early breast cancer who are node‐negative, thereby sustaining the potential morbidity of the procedure. Sentinel node is the first regional node to receive lymph from the breast and accurately represents the metastatic status of the primary cancer. Sentinel node biopsy appears to offer an alternative to routine axillary lymph node dissection for staging patients with breast cancer. (Supported in part my MURST and CNR, Italy)