Sonography of palpable breast cancer

Abstract

Purpose. Because of the increasing use of sonography to rule out cancer in women with palpable breast abnormalities, this study was performed to determine the rate of sonographically occult malignancy in this clinical setting.Methods. Women who were recommended for biopsy based on mammographic and/or clinical findings underwent breast sonography. This study retrospectively analyzed the subset of patients with palpable malignant lesions. Lesions were classified as visible or occult on mammography and sonography. Patients without a tissue diagnosis of tumor were excluded.Results. Of 1,346 masses that underwent biopsy or aspiration, 616 lesions were palpable, and of these, 293 were malignant. Sonography detected all 293 palpable malignant lesions (95% confidence interval for sensitivity, 99-100%). Eighteen lesions were mammographically occult. The median lesion size as determined by sonography was 1.8 cm; for the lesions that were mammographically occult, the median size was 1.6 cm. The most common histopathologic diagnosis for both groups of lesions was infiltrating ductal carcinoma.Conclusions. All palpable malignant breast lesions were visible by sonography in patients in whom a biopsy was recommended. However, we caution that until the false-negative rate of sonography for equivocal palpable abnormalities is determined prospectively, sonography cannot be accurately applied to rule out malignancy in this setting. A s a result of the Breast Cancer DetectionDemonstration Project (BCDDP) and early screening studies, we know that approximately 9-16% of breast cancers are mammographically occult and detected only by palpation. 1,2 However, the distinction by physical examination of physiologic nodularity from abnormal masses can be

Diagnostic Accuracy of Ultrasound in Palpable Breast Lesions

“…The reason behind higher sensi vity in our study might be due to the pa ents presented in advanced stages of the disease. In our study, the reason for referral for ultrasound was a 14,16 palpable mass in the breast similar to the previous studies. Kolb et al reported sensi vity of 78.6% whose pa ents were of younger age group (≤50 years) and had late stage of the 17 disease.…”

Prospective evaluation of the value of combined mammographic and sonographic assessment in patients with palpable abnormalities of the breast

“…In a retrospective analysis of 293 palpable malignant lesions, sonography detected all cancers; 18 (6.1%) of these 293 cancers were mammographically occult. 15 In our series, sonography identified 2 palpable cancers (2 [14.2%] of 14) that were mammographically occult. Nineteen of the 60 lesions with suspicious findings were mammographically occult, as were 66 of the 165 benign abnormalities.…”

Acute lymphoblastic leukemia relapse in the breast diagnosed with gray‐scale and color Doppler sonography

“…Primary breast carcinoma and metastases to the breast in children and adolescents are extremely rare. [5][6][7] The primary tumors that most frequently metastasize to the breast are rhabdomyosarcomas, particularly the alveolar variety; non-Hodgkin's lymphoma; and leukemia. 2 Histiocytosis, medulloblastoma, neuroblastoma, renal carcinoma, urinary bladder carcinoma, and melanoma have also been reported to metastasize to the breast.…”