The role of US in breast imaging

Article Abstract:

It was originally hoped that ultrasound (US) would become a major diagnostic tool for breast cancer and that it might even replace mammography (an X-ray technique). These high hopes have not materialized. Presently, US is mainly used to differentiate between cysts and solid masses in the breast. US is 96 to 100 percent accurate in the diagnosis of cysts when proper diagnostic criteria are followed. It is important that good quality, high-frequency equipment be used in order to obtain accurate results. Detection of cysts is important because simple cysts do not have to be biopsied. However, if the sonogram (US picture) does not show a discrete cyst, diagnosis should not be made on the basis of the sonogram alone and biopsy should be performed. US can also be useful in visualizing masses that are palpable (can be felt) but cannot be seen by mammography. This can determine if the mass is cystic or solid. If the mass cannot be visualized with either mammography or sonography, biopsy is recommended. US is also important in screening young patients, whose breasts are more sensitive to radiation, and US can be useful in finding areas of abscess in an infected breast. US is also useful for evaluating masses located such that they cannot be seen by mammography and in detecting positive (cancerous) lymph nodes. These represent the uses of US, but there are purposes that US should not be used for. It was hoped that US could be used to differentiate benign from malignant masses in the breast, but the technology at present is not sensitive enough to make such determinations. Technical advances may change this situation. US should also not be used as a screening procedure for women with no symptoms and those with dense breast tissue; it has an unacceptably high false-positive rate in these cases. US can be a useful tool in evaluating the breast, but the cost of the procedure should be compared with the potential for gaining useful information. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Ultrasound imaging, Fibrocystic breast disease

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Color Doppler signals from breast tumors: work in progress

Article Abstract:

Malignant tumors will often cause formation of new, but abnormal, blood vessels in the vicinity of the tumor. This aggregation of abnormal vessels produces flow that can be detected using color Doppler ultrasound (US). This technique maps and measures flow by using high-frequency sound to produce images in which color is used to represent different flow velocities. The abnormal vessels produced by malignant tumors appear as high-velocity signals on the flow maps produced. This study examined the sensitivity of color Doppler in detecting blood flow in breast tissue and its possible diagnostic use in detecting malignant and benign tumors. Color Doppler US was performed on 60 patients who had breast abnormalities that were either palpable masses or regions of breast thickening. Conventional diagnostic procedures found malignant tumors in 21 of the patients and benign tumors in 38 of the patients. In the 21 malignant cases, color Doppler detected tumor flow in 20 of them, with 9 cases showing moderate to high flow intensities. Vessel density in the tumors averaged 0.5 vessels per square centimeter. The one case that did not have detectable flow also did not show clinical symptoms when other imaging methods were used. The benign tumors showed little or no flow when measured by color Doppler and very low vessel densities (0.01 vessels per square centimeter). These results indicate that color Doppler may be very useful in characterizing breast tumors. Malignant tumors show detectable, moderate to high flow rates with increased vessel densities, as opposed to benign tumors, which have little or no detectable flow rates and low vessel densities. Further confirmation of these results could allow use of this technique to decide which detectable breast abnormalities should be further examined by biopsy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Doppler ultrasonography, Mammary ultrasonography

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Indications for breast imaging in women under age 35 years

Article Abstract:

Women aged 13-34 years who were referred by their physicians for imaging due to abnormalities discovered ;in their breasts may not need continual imaging study after an initial imaging. Of 335 women studied, 123 were suspected of having breast cancer. Seventy three of the suspicious cases had biopsies; only six actually had cancer. Four of the six were significantly helped by the existence of an image of their abscesses. Those women who do not have masses, nipple discharge or history of breast cancer are best followed up clinically instead of re-screened for imaging. Imaging is best used for women over 35, or those with palpable masses in their breasts.

Health aspects, Management, Women, Cancer, Women's health, Mammography, Cancer diagnosis

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