title: Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound.
abstract: OBJECTIVE
  The aim of this study was to evaluate the contribution of bilateral whole-breast ultrasound (BBUS) to the diagnosis and management of women with newly diagnosed breast cancer.
  
  
  METHODS
  Over a period of 6 months, 102 women presenting with breast cancer underwent BBUS. Data were collected on clinical findings, radiology, histology and surgical outcome. These women were compared with a control group of 124 women presenting over a similar 6-month period 1 year previously, who had undergone targeted breast ultrasound.
  
  
  RESULTS
  Multicentric/multifocal tumours were demonstrated in 35 (34%) of the 102 participants and in 18 (15%) of the 124 controls, a statistically significant difference (Fisher's exact test, p = 0.001). Multiple tumours were diagnosed preoperatively in 18% of the study population compared with 8% of the controls, and BBUS identified invasive multifocal/multicentric tumours in significantly more women in the study population (11 versus 1 control) (Fisher's exact test, p = 0.019). Contralateral cancer was diagnosed in 4 women in the study population and none in the control population (Fisher's exact test, p = 0.040). Surgical review showed that the surgical management changed significantly in 8% (95% confidence interval 4 to 14%) of cases in the study population following BBUS. The increase in the number of women undergoing benign biopsies in the study population (10 versus 5 controls) was not statistically significant (Fisher's exact test, p = 0.11).
  
  
  CONCLUSIONS
  BBUS increased the preoperative diagnosis of multiple tumours in women presenting with primary breast cancer, resulting in a management change in 8% of cases.
authors.affiliation: South West London Breast Screening Service, University College, London, UK. louise.wilkinson@stgeorges.nhs.uk
authors.forename: L S
authors.initials: LS
authors.lastname: Wilkinson
authors.forename: R
authors.initials: R
authors.lastname: Given-Wilson
authors.forename: T
authors.initials: T
authors.lastname: Hall
authors.forename: H
authors.initials: H
authors.lastname: Potts
authors.forename: A K
authors.initials: AK
authors.lastname: Sharma
authors.forename: E
authors.initials: E
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary