The effect of ipsilateral whole breast ultrasonography on the surgical management of breast carcinoma.
BACKGROUND
Patients can be selected for breast conservation therapy using mammography and physical examination. Whole breast ultrasonography has been shown to identify lesions not seen on mammography. This study sought to determine how often whole breast ultrasonography changes the surgical management of breast cancer.


METHODS
All patients with stage 1 and 2 breast cancer undergoing whole breast ultrasonography were identified. A change in surgical management was defined as the identification by ultrasonography alone of foci of carcinoma greater than 1 cm from the primary tumor site or in another quadrant of the breast.


RESULTS
There were 1385 breast cancer patients; 31% had ultrasonography. Eighteen percent of patients had abnormalities identified by ultrasonography alone. Changes in management occurred in 2.8%. The additional lesions led to four wider resections and eight mastectomies. Patients with ultrasonography abnormalities were significantly younger, and more likely to have histologic grade 2 or 3 disease.


CONCLUSIONS
These findings do not support the routine use of ultrasonography in all breast cancer patients. Significant abnormalities were more commonly seen among younger patients with higher grade lesions.
Golshan
Mehra
M
Department of Surgery, Lynn Sage Breast Center, Northwestern University, 251 East Huron St, Galter 13-174, Chicago, IL 60611, USA. mgolshan@partners.org
Fung
Bing B
BB
Wolfman
Judith
J
Rademaker
Alfred
A
Morrow
Monica
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D010808:Physical Examination; D016217:Ultrasonography, Mammary