Relevance of sonographic criteria for differential diagnosis of mammary tumours

Abstract

Objective: A prospective study was performed to determine the relevance of sonographic criteria for the differentiation of mammary tumours using high-resolution sonography. Methods: Two high-resolution ultrasonographic devices (7.5 and 10 MHz linear array transducer) were used for preoperative examination of 310 patients with focal breast findings (including 97 cancers and 213 benign breast diseases). The diagnostic relevance of sonographic criteria was analysed for the differentiation of breast cancer among all surgically removed tumours or punctured lesions. This was done by calculating sensitivity, specificity, positive and negative predictive values and the odds ratio (OR). OR is very much suited to summarize the statistical findings from benign lesions. Results: The irregular and ill-defined tumour margin (OR=378), change of breast architecture (OR=230), absence of lateral edge shadowing (OR=49) as well as non-compressibility (OR=31) proved to be the best criteria. Low internal echogenicity (OR=0.45) and the presence of internal echo patterns (OR=0.69) did not indicate malignancy. Conclusion: The best criteria for distinguishing between malignant and benign tumours using high-resolution ultrasound are the irregular and ill-defined tumour margin and alterations of breast architecture.