Ultrasound detection of nonpalpable mammographically occult malignancy.
OBJECTIVE
To evaluate the prevalence of occult malignancy with screening breast ultrasound.


METHODS
All ultrasound-guided core needle breast biopsies performed between January 1, 1999, and June 30, 2001, were retrospectively reviewed. Lesions were identified during screening breast ultrasound in high-risk women with no mammographic or palpable abnormality in either breast, a unilateral mammographic or palpable abnormality in the contralateral breast, or a unilateral mammographic or palpable abnormality in a different quadrant of the same breast. All ultrasound-detected lesions were histologically verified.


RESULTS
Six hundred and fifty-two women with a mean age of 49 years underwent 698 biopsies during the study period. Three hundred and forty-nine of these lesions were detected at screening breast ultrasound. Out of 349, 11 (3.2%) had a mammographically and clinically occult malignancy. Nine cancers were found in women with no mammographic or palpable abnormality. Two cancers were found in the same breast as the mammographic or palpable abnormality. None were found in the breast contralateral to a palpable or mammographic abnormality.


CONCLUSIONS
Screening breast ultrasound of high-risk women has a similar detection rate for occult carcinoma as screening mammography, but has a low positive predictive value in cases where biopsy is performed.
Mount Sinai Medical Center, Department of Radiology, New York, NY 10029, USA. william.simpson@mountsinai.org
William L
WL
Simpson
George
G
Hermann
Dana R
DR
Rausch
Joshua
J
Sherman
Stephen A
SA
Feig
Ira J
IJ
Bleiweiss
Shabnam
S
Jaffer
Abraham
A
Port
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*