[Impact of breast ultrasound screening in gynecological practice].
OBJECTIVE
To define the value of whole breast ultrasound for breast cancer detection in primary women's health care in gynecological routing practice.


METHODS
Among women who were operated at the breast center of the German Diagnostic Clinic (DKD) in the year 2007, we selected different indications for the examinations which were relevant for the detection of breast lesions.


RESULTS
Twenty-one of 86 breast cancers (24 %) which were treated at the DKD in the year 2007 were detected only because of an individual ultrasound screening examination. None of these women had abnormal clinical findings and only 8 of these women had abnormal mammograms. The majority of these cancers were early stages, pT1a/b. In this group of patients, only 8 benign lesions detected by ultrasound were operated. This corresponds to a ratio of benign vs. malignant operations of 0.4 to 1, which is far superior to the recommendations of international guidelines for quality assurance.


CONCLUSIONS
Our results show that ultrasound screening considerably increases the detection of early breast cancers without increasing the rate of unnecessary biopsies. This should encourage gynecologists to learn and perform systematic breast ultrasound examinations and to increase their own performance by continuous training. We can expect that additional studies will prove breast ultrasound to be a powerful method for improving breast cancer detection. Currently available state-of-the-art ultrasound technology allows for early detection, but further education and quality control are important for implementation in nation-wide health care.
Madjar
H
H
Gynäkologie, DKD, Wiesbaden. madjar.gyn@dkd-wiesbaden.de
Becker
S
S
Doubek
K
K
Horchler
T
T
Mendoza
M
M
Moisidis-Tesch
C
C
Näther
B
B
Niebling
K
K
Pröls
U
U
Schardt
A-R
AR
Ulrich
S
S
Zahn
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D042241:Early Diagnosis; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D011785:Quality Assurance, Health Care; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary