Published in:
01-12-2008
Benefit of Ultrasonography in the Detection of Clinically and Mammographically Occult Breast Cancer
Authors:
Sharon W. W. Chan, Polly S. Y. Cheung, Stefanie Chan, Suk Sze Lau, Ting Ting Wong, Michael Ma, Ada Wong, Yuen Ching Law
Published in:
World Journal of Surgery
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Issue 12/2008
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Abstract
Objective
The purpose of this study was to evaluate the performance of high-resolution ultrasonography in the detection of clinically and mammographically occult breast cancer.
Materials and methods
From September 2003 to November 2006, a total of 1485 patients were confirmed to have in situ or invasive breast cancer in Hong Kong Sanatorium and Hospital Breast Care Centre. All patients underwent mammography (MMG) and/ or sonography (USG) evaluation. Patients’ age and size of tumor detected by USG alone were compared with those detected by MMG.
Results
Altogether, 222 patients (17%) had positive imaging findings on USG only, among which 22 (13%) patients had nonpalpable tumors. Performing USG increased the cancer detection rate among clinically and mammographically occult breast lesions by 14.3%. The mean size of the tumors detected only by USG was 1.98 cm, which was not significantly different from the mean size of tumor detected by MMG (1.46) (p = 0.23). This remains true in the group of patients with nonpalpable tumors (1.36 vs. 1.46 cm, p = 0.88). The sensitivity of USG is 91%, which is significantly higher than that of MMG (78%) (p = 0.001). This remains true in patients age <40 or ≥40, tumor grading I toIII, and LVI +/− cases. However, MMG had higher sensitivity in the group of patients with nonpalpable tumors (73% vs. 62%, p = 0.01) and noninvasive cancers (72% vs. 69%, p = 0.01).
Conclusions
The use of high-resolution USG may lead to detection of a significant number of occult cancers that are no different in size from nonpalpable mammographically detected lesions.