Mammography and subsequent whole-breast sonography of nonpalpable breast cancers: the importance of radiologic breast density.
OBJECTIVE
Our purpose was to determine the contribution of mammography followed by sonography for the detection of nonpalpable breast cancers in Breast Imaging Reporting and Data System (BI-RADS) density grades 1-4 breasts, in grades 1 and 2 breasts, and in grades 3 and 4 breasts.


METHODS
The results of physical, mammographic, and sonographic examinations performed in 4236 patients were reviewed to determine the sensitivities of mammography and sonography for the detection of nonpalpable breast cancers and to calculate the relative risk for detecting nonpalpable breast cancers using sonography in comparison with mammography in density grades 1-4, grades 1 and 2, and grades 3 and 4 breasts. Sonography was performed after mammographic interpretation.


RESULTS
Sensitivities of mammography and subsequent sonography for the detection of nonpalpable breast cancers were 69% and 88% in grades 1-4, 80% and 88% in grades 1 and 2, and 56% and 88% in grades 3 and 4 breasts, respectively. The relative risk for detecting nonpalpable breast cancers using sonography was statistically significantly greater than that for detecting nonpalpable breast cancers using mammography in grades 1-4 (relative risk, 1.29; p = 0.024) and in grades 3 and 4 (relative risk, 1.57; p = 0.013) but not in grades 1 and 2 (relative risk, 1.1; p = 0.445) breasts.


CONCLUSIONS
Sonography is a useful adjunct after mammography for the detection of nonpalpable breast cancer, particularly in the dense breast.
Leconte
Isabelle
I
Department of Radiology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Ave. Hippocrate 10, B-1200 Brussels, Belgium.
Feger
Chantal
C
Galant
Christine
C
Berlière
Martine
M
Berg
Bruno Vande
BV
D'Hoore
William
W
Maldague
Baudouin
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010173:Palpation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016217:Ultrasonography, Mammary