Fritz K.W. Schaefer MD, Presenter: Nothing to Disclose

Alexander Katalinic MD, Abstract Co-Author: Nothing to Disclose

Philipp J. Schaefer MD, Abstract Co-Author: Nothing to Disclose

Christine Wefelnberg, Abstract Co-Author: Nothing to Disclose

Berndt Order, Abstract Co-Author: Nothing to Disclose

Ingrid Schreer MD, Abstract Co-Author: Nothing to Disclose

Walter Jonat MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To evaluate additional ultrasound (US) examination to mammography in case of breast density ACR III and IV, in symptomatic women or women at risk. All patients were examined in the project “quality assurance in breast cancer diagnosis” (QuaMaDi project) in Schleswig Holstein, Germany. The process-orientated and comprehensive quality management project was implemented to improve the standard of breast cancer diagnosis.

A prospective cohort with a total of 59514 patients and 102744 mammograms was initiated between 2001 and 2005. Breast US was indicated in all women with breast density ACR III and IV, in case of a suspicious clinical examination, and in case of masses or asymmetry in mammography. Abnormalities were defined positive, if biopsy findings revealed malignancy, and negative, if biopsy findings or all examinations turned out to be benign.

In total, 1019 breast cancers were detected. 116 mammographically occult breast cancers were diagnosed by ultrasound out of 62006 cases (1.9/1000 cases). Thus, mammography plus US detected 12.8% (116/903) breast cancers more than mammography alone did (903). In group ACR III/IV, 611 breast cancers were detected. Thus, mammography plus US detected 15.9% (84/527) breast cancers more than mammography alone (527).

For ACR III and IV, supplementary US to mammography vs mammography alone resulted in a significant increase of breast cancer detection rate of 15.9%.

US is essential in detection of breast cancer in case of ACR III and IV.

Schaefer, F, Katalinic, A, Schaefer, P, Wefelnberg, C, Order, B, Schreer, I, Jonat, W, et al, , Evaluation of Additional Ultrasound to Mammography in Case of Breast Density ACR III/IV: Is There a Higher Detection Rate of Breast Cancer? Analysis of 102744 Diagnostic Processes.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016643.html