Surgical office-based ultrasound of the breast.
How surgical office-based ultrasound (US) influences the management of nonpalpable, new or increasing size, mammogram-detected breast masses was evaluated. Ninety-seven patients had diagnostic US only; of these, 67 had their mass diagnosed as a simple cyst, and 30 had a negative US. Fifty-three additional patients underwent US-guided aspiration and/or biopsy (US-GAB) of their breast mass after diagnostic US. Of 12 patients with diagnostic US of "simple cyst," US-GAB confirmed each to be cysts. Of five patients with diagnostic US of "fibroadenoma," four had fibroadenomas and one had insufficient tissue on US-GAB. In all five cases a fibroadenoma was diagnosed at open biopsy. Of 27 patients with diagnostic US of "indeterminate" (cyst versus solid/complex cyst), 15 had cysts, one had a fibroadenoma, and one had a papilloma on US-GAB; the latter two were confirmed on open biopsy. Ten of these 27 patients had fibrocystic change identified on US-GAB; six were benign on open biopsy, and four had no change on follow-up mammogram. Of nine patients with diagnostic US of "suspicious," three had carcinomas, five had fibrocystic change, and one had insufficient tissue on US-GAB; three cancers were confirmed, and the remaining six were benign on open biopsy. There were no false positives and no false negatives among those patients undergoing US-GAB. In conclusion, office-based ultrasound of the breast performed by surgeons can accurately diagnose nonpalpable simple cysts and can accurately guide needle aspiration and/or biopsy of probable fibroadenomas, indeterminate, or suspicious masses for diagnosis of cystic, benign solid, or malignant lesions.
Staren
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ED
Department of General Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA.
D001707:Biopsy, Needle; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D002828:Choristoma / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging / Q000473:pathology; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005500:Follow-Up Studies; D013502:General Surgery; D006801:Humans; D006965:Hyperplasia; D008198:Lymph Nodes / Q000473:pathology; D008327:Mammography; D010212:Papilloma / Q000000981:diagnostic imaging / Q000473:pathology; D010824:Physicians' Offices; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary