title: Ultrasound as a complement to mammography and breast examination to characterize breast masses.
abstract: This study was designed to determine if complementary ultrasound (US) imaging and Doppler could decrease the number of biopsies for benign masses. A total of 761 breast masses were sequentially scored on a level of suspicion (LOS) of 1-5, where 1 represented low, and 5 was a high suspicion of malignancy, for mammography, US, and color flow with pulse Doppler (DUS). After biopsy, the results were analyzed using 2 x 2 contingency tables and ROC analysis, for mammography alone and in combination with US and DUS. The addition of US increased the specificity from 51.4% to 66.4% at a prevalence of 31.3% malignancy. ROC analysis showed that the addition of US significantly improved the performance over mammography alone in women < 55 years old (p = 0.049); > 55 years old (p = 0.029); masses < 1 cm (p = 0.016) and masses > 1 cm (p = 0.016). These results show that the addition of US to mammography alone could substantially reduce the number of breast biopsies for benign disease.
authors.affiliation: Radiology, Ob/Gyn & Surgery, Yale University School of Medicine, New Haven, CT 06520, USA. Kenneth.Taylor@yale.edu
authors.forename: Kenneth J W
authors.initials: KJ
authors.lastname: Taylor
authors.forename: Christopher
authors.initials: C
authors.lastname: Merritt
authors.forename: Catherine
authors.initials: C
authors.lastname: Piccoli
authors.forename: Robert
authors.initials: R
authors.lastname: Schmidt
authors.forename: Glenn
authors.initials: G
authors.lastname: Rouse
authors.forename: Bruno
authors.initials: B
authors.lastname: Fornage
authors.forename: Eva
authors.initials: E
authors.lastname: Rubin
authors.forename: Dianne
authors.initials: D
authors.lastname: Georgian-Smith
authors.forename: Fred
authors.initials: F
authors.lastname: Winsberg
authors.forename: Barry
authors.initials: B
authors.lastname: Goldberg
authors.forename: Ellen
authors.initials: E
authors.lastname: Mendelson
mesh_terms: D001706:Biopsy; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D016504:Breast Self-Examination; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016217:Ultrasonography, Mammary