Nariya Cho MD, Presenter: Nothing to Disclose

Woo Kyung Moon MD, Abstract Co-Author: Nothing to Disclose

Boo-Kyung Han MD, Abstract Co-Author: Nothing to Disclose

To evaluate the ultrasound (US) and histopathologic features of supplementary US-detected breast cancers.

Supplementary whole breast US was performed in 23,000 women in addition to negative screening mammography. US images that led to the detection of cancer (n=87), and negatively reported, corresponding mammograms were collected. Three radiologists blindly evaluated the mammograms whether the cancer was visible retrospectively. Eighty lesions in 80 women were determined to be identified with US alone. Eighty consecutive-screening mammographically detected cancers were searched for a control group. Two experienced radiologists analyzed US images of these 160 lesions according to the BI-RADS lexicon without knowledge of the detected modality and histology. The US and histopathologic findings were compared between the two groups.

Between US and mammographically detected cancers, significant difference was found for the following US findings; shape (oval or round 25% vs. 10%, irregular 75% vs. 90%; P=.013), margin (circumscribed 13% vs. 4%; P=.043, indistinct 30% vs. 16%; P=.039, spiculated 3% vs. 19%; P=.001), boundary (abrupt interface 79% vs. 53%, echogenic halo 21% vs. 48%; P<.001), posterior acoustic features (no posterior echo 70% vs. 53%, enhancement 13% vs. 3%, shadowing 10% vs. 30%; P=.01), and final assessment (category 3: 4% vs. 3%, category 4a: 34% vs. 9%, category 4b: 39% vs. 23%, category 4c: 21% vs. 29%, category 5: 3% vs. 38%; P<.001). US-detected cancer was smaller (mean 1.2±0.9 cm vs. 1.9±1.3 cm; P<.001), more stage I invasive carcinomas (80% vs. 55%; P=.001) than mammographically detected cancer. However, there were no significant differences for node-negative cancer rates (90% vs. 85%) and histologic type (invasive carcinoma 81% vs. 74%, DCIS 19% vs. 26%).

US-detected breast cancer often manifested as an oval or round mass without boundary echo and posterior acoustic change. The majority (80%, 64 of 80) of US-detected cancer was stage I invasive carcinoma.

Supplementary whole breast US in addition to negative screening mammography can demonstrate small invasive cancers and being familiar with US findings of these cancers is recommended.

Cho, N, Moon, W, Han, B, Characteristics of Breast Cancers Detected by Supplementary Ultrasound.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4438210.html