Ultrasound is now better than mammography for the detection of invasive breast cancer.
OBJECTIVE
This study investigated the use of ultrasound (US) as a first-line diagnostic tool.


METHODS
All women attending our breast center underwent bilateral whole-breast US in addition to all other investigations, and results were documented prospectively and preoperatively.


RESULTS
Of 796 patients with breast cancer, US was positive in 710 (89%) and mammography in 706 (89%) (P = not significant). Either US or mammogram was positive in 770 (97%). Of 537 (67%) symptomatic patients, US was positive in 497 (93%) and mammography in 465 (87%). Either US or mammography was positive in 515 (96%). Of 259 (33%) screening patients, 220 (85%) had invasive cancer. US was positive in 195 (89%) and mammography in 203 (92%) (P = not significant). Either US or mammography was positive in 217 (99%). Of 39 screening patients with ductal carcinoma in situ (5% of all patients), US was positive in 18 (46%) and mammography in 38 (97%).


CONCLUSIONS
US is significantly better than mammography for detecting invasive breast cancer (92% patients). The combination of US and mammography is significantly better than either modality used alone, together resulting in 9% more breast cancers detected.
Benson
S R C
SR
St. Marks Women's Health, 10 St. Marks Rd., Remuera, P.O. Box 99455, Auckland, New Zealand. w.benson@smwh.co.nz
Blue
J
J
Judd
K
K
Harman
J E
JE
D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D014463:Ultrasonography