Evaluation of high-risk patients with dense breast on high-resolution ultrasound for screening and detection of breast cancer where mammography is of low significance

Abstract

Abstract Background: Early diagnosis of breast cancer is a challenging problem in high-risk patients with dense breast. The risk of breast cancer is many fold higher in dense breast as compared to nondense on one side with limited screening or diagnostic role of mammography on the other side. The aim of our study is to elaborate the role of high-resolution ultrasonography (HR-USG) as adjunct modality to overcome this limitation. Materials and Methods: This is a prospective observational study conducted in the breast care clinic of a tertiary care cancer hospital. Totally, 2720 patients were enrolled for mammography. Out of these, 339 patients were reported according to Breast Imaging Reporting and Data System (BIRADS) as 0 (inconclusive) and were suggested for further evaluation by other modalities. All patients reported for mammography as BIRADS 0, were included in this study for HR-USG. Results: On HR-USG, 33.4% of patients with dense breast were shown to have suspicious (BIRADS 5) lesions. 21.7% had simple cysts. Fibro adenomas and abscess were seen in 18% and in 15% of patients, respectively. Other findings were duct ectasia (4.3%) and galactocele (3.4%). 1.4% of patients were normal on HR-USG. Conclusion: Our study showed HR-USG as a modality of choice that supersedes the diagnostic efficiency of mammography in patients with dense breasts thus enhances early detection and better treatment of breast cancer, decreasing mortality owning to delay in diagnosis.