Innovations in design of a dedicated breast scanner resulted in automation of the scanning process, the production of high resolution images of the whole breast and an efficient mode of image review. The results of clinical evaluation of the prototype of this breast scanner investigating normal breasts as well as benign and malignant breast lesions are presented.

Forty-four pathologically proved mammary carcinomas were studied by clinical examination, xeroradiography, and ultrasonography with a dedicated whole-breast scanner. Abnormalities reflecting carcinoma were shown by echography in 90% of cases and xeromammography in 97%. Ultrasonic manifestations of malignancy were separated into four categories: (a) a solid, hypoechoic mass; (b) a hyperechoic focus; (c) an irregular, echogenic zone of parenchymal disruption; and (d) an atypical cystic mass. Dedicated ultrasound instruments enhance interpretation and improve differential diagnostic capability. Sonography demonstrates abnormalities better and permits superior definition of abnormal characteristics in a dysplastic breast than in a fatty, atrophic breast, while xeromammography may be more reliable in postmenopausal women with fatty breasts than in women with mammographically dense breasts. One limitation of current ultrasound equipment is the inability to consistently demonstrate microcalcification.

Automated sonomammography and xeromammography were compared in a group of 293 patients referred for a variety of symptomatic and asymptomatic conditions. Twenty of the 293 patients had mammographic evidence of carcinoma that was confirmed pathologically. Seventeen of these patients had sonomammographic evidence of a solid mass; 11 of these demonstrated signs of malignancy, such as irregular border, and desmoplastic reaction manifested by thickening of Cooper's ligaments, skin retraction, periductal fibrosis or disruption of architecture. Statistical analysis of the results reveals that a high degree of sensitivity and specificity in the diagnosis of malignant breast disease can be accomplished with automated sonomammography.