A prospective analysis of office-based breast ultrasound.
OBJECTIVE
To determine the usefulness of office-based breast ultrasound.


METHODS
Prospective, nonrandomized study.


METHODS
Academic-affiliated community teaching hospital.


METHODS
Among 653 consecutive patients seen in our office during a 30-month period, we performed 660 ultrasound examinations. The presenting complaint included a palpable mass in 53%, abnormal mammogram in 39%, and nipple discharge or retraction in 3%.


METHODS
Ultrasound examination was performed using a handheld 7.5-MHz linear array transducer. Findings and pertinent clinicopathologic data were recorded prospectively in our Breast Ultrasound Registry.


METHODS
Contribution of breast ultrasound to diagnosis and treatment.


RESULTS
The sonogram was normal in 201 cases (30%), showed duct ectasia in 20 cases (3%), a simple cyst or seroma in 101 cases (15%), and a focal complex or solid abnormality in 338 cases (51%). Among the last group, 114 (97%) of 118 lesions thought to be benign on ultrasonography proved to be benign, whereas 13 (12%) of 111 indeterminate and 72 (75%) of 96 sonographically suspicious lesions proved to be cancer (including 13 cases with normal mammograms). Ultrasonographic features of malignancy included an anteroposterior-to-lateral dimension ratio of 1 or greater, heterogeneous hypoechoicity, irregular shadowing, and fuzzy and/or jagged margins. Ultrasound-guided needle biopsy accurately diagnosed 46 benign nonpalpable lesions and 20 malignant nonpalpable lesions.


CONCLUSIONS
These data suggest that ultrasonography is a useful adjunct to clinical and mammographic evaluation of breast disease. Breast ultrasound identifies cysts, aids in differentiating benign from malignant lesions, and facilitates office needle biopsy of nonpalpable abnormalities, permitting timely and cost-effective patient care.
Hieken
T J
TJ
Department of Surgery, Rush North Shore Medical Center, Skokie, Ill 60076, USA.
Velasco
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000295:instrumentation; D016217:Ultrasonography, Mammary / Q000295:instrumentation