title: Detection of microcalcifications in women with dense breasts and hypoechoic focal lesions: comparison of mammography and ultrasound.
abstract: OBJECTIVE
  Microcalcifications in the breasts can point to breast cancer. However, there is great morphologic variety, and microcalcifications do not always correlate with malignancy. We conducted a prospective study to compare ultrasound and mammography in the detection of microcalcifications following sonographic diagnosis of a hypoechoic focal lesion in women with dense breast composition.
  
  
  METHODS
  A total of 104 lesions potentially associated with microcalcifications (82 malignant and 23 benign lesions) were included in the study. The breast was examined by ultrasound (9 MHz, Aplio XG/500) with additional use of MicroPure imaging for the demonstration and evaluation of microcalcifications. The presence of a focal lesion was verified and microcalcifications were counted at ultrasound and mammography by blinded readers. The sensitivity and specificity were determined, and ROC analysis and AUC analysis were performed.
  
  
  RESULTS
  The women had a median age of 51 years. The average number of microcalcifications detected by sonography (2.12 ± 2.77) and mammography (3.59 ± 6.35) was not significantly different (p > 0.05). Correlation of the techniques was adequate (Pearson's r = 0.616, p < 0.0001; Spearman's rho = 0.654, p < 0.0001). The intraclass correlation coefficient was K = 0.382 ± 0.072 (p < 0.0001), also indicating adequate agreement of both techniques. The sensitivity and specificity were 70%/30% for MicroPure and 45%/55% for mammography. The positive predictive value of mammography was superior to that of MicroPure (88% vs. 78%).
  
  
  CONCLUSIONS
  The sonographic detection of microcalcifications with MicroPure imaging in breasts with a hypoechoic focal lesion correlates well with digital mammography.
authors.affiliation: Institute of Radiology and Ultrasound Research Laboratory, University of Berlin, Charité, Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Grigoryev
authors.affiliation: Department of Obstetrics and Gynecology and Ultrasound Research Laboratory, University Berlin, Charité, Berlin.
authors.forename: A
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Institute of Radiology and Ultrasound Research Laboratory, University of Berlin, Charité, Berlin.
authors.forename: L
authors.initials: L
authors.lastname: Plath
authors.affiliation: Institute of Radiology and Ultrasound Research Laboratory, University of Berlin, Charité, Berlin.
authors.forename: T
authors.initials: T
authors.lastname: Durmus
authors.affiliation: Institute of Nephrology, University Berlin, Charité, Berlin.
authors.forename: T
authors.initials: T
authors.lastname: Slowinski
authors.affiliation: Institute of Radiology, St. Joseph-Stift, Bremen.
authors.forename: F
authors.initials: F
authors.lastname: Diekmann
authors.affiliation: Institute of Radiology and Ultrasound Research Laboratory, University of Berlin, Charité, Berlin.
authors.forename: T
authors.initials: T
authors.lastname: Fischer
mesh_terms: D001941:Breast Diseases / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D016217:Ultrasonography, Mammary