Between August 1985 and November 1987, 150 patients with 167 biopsy-proved lesions were examined with magnetic resonance (MR) imaging enhanced with gadolinium diethylenetriaminepentaacetic acid, mammography, and palpation. Of these patients, 113 with 123 lesions were also examined with ultrasound. Enhancement above 300 normalized units (NU) on MR images was considered significant; between 250 and 300 NU, borderline; and below 250, nonsignificant. All 27 fibroadenomas and 70 of 71 carcinomas showed significant enhancement; one carcinoma showed borderline enhancement. Nonproliferative dysplasia showed nonsignificant enhancement in 15 of 16 cases and significant enhancement in one, whereas proliferative dysplasia showed usually diffuse enhancement varying from nonsignificant (five of 30 cases) to borderline (five of 30 cases) to significant (20 of 30 cases). In the nonblind evaluation of the modalities, MR imaging compared favorably. When limitations of the technique were considered, MR imaging seemed beneficial as a supplement in selected, diagnostically difficult cases.

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Ultrasound has become increasingly important in the management of benign breast disease. The main reasons are its ability to distinguish between cystic and solid lesions, its special advantages in examining the dense breast, and the absence of potential radiation hazard. This paper evaluates the specificity of automated ultrasound in the diagnosis of benign lesions. The usefulness of the signs established for the diagnosis of benign masses is analyzed. Atypical lesions are discussed and the role of ultrasonography in the differential diagnosis of benign lesions is reviewed.