Advertisement

Ultrasound of the Breast, Including Interventions: An Update

  • Alexander Mundinger

Abstract

High-resolution ultrasound (US) has made progress in detecting and characterizing breast lesions, with frequencies between 7 and 18 MHz in combination with advanced tissue imaging technologies, such as compound and harmonic imaging, volume scanning, modern color flow, and elastography. The updated Breast Imaging Reporting and Data System (BI-RADS) lexicon incorporates these new technological concepts and their impact on management. To date, description of a lesion should cover the new BIRADS US categories of vascularity and elasticity as associated findings. US constitutes the method of choice for assessing women with clinical signs and symptoms of breast cancer. Fundamental US enhances sensitivity for detecting cancer by 6–30% in symptomatic breast-cancer patients. In risk patients with radiodense breasts, additive US to screening mammography improves the supplemental diagnostic detection rate after negative mammography by three to four per 1,000 women with dense breasts.The generally accepted role of US in population-based screening focuses on assessing suspicious mammographically detected lesions.

Keywords

Breast Lesion Core Needle Biopsy Color Reproduction Additional Diagnostic Yield Primary Axillary Lymph Node Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Mundinger A (2011) Ultrasound of the breast including interventions: an update. In Hodler J, von Schulthess GK, Zollikofer ChL (eds) Diseases of the heart, chest and breast 2011–2014. Springer-Verlag Italia, Milano, pp 259–266Google Scholar
  2. 2.
    Teboul M (2010) Advantages of ductal echography (DE) over conventional breast investigation in the diagnosis of breast malignancies. Med Ultrason 2:32–42Google Scholar
  3. 3.
    Weismann C, Mayr C, Egger H, Auer A (2011) Breast sonography — 2D, 3D, 4D ultrasound or elastography? Breast Care 6:98–103PubMedCrossRefGoogle Scholar
  4. 4.
    Mundinger A, Wilson ARM, Weismann C et al (2010) Breast ultrasound — update. Eur J Cancer Supplements 8:11–14CrossRefGoogle Scholar
  5. 5.
    Madjar H, Sauerbrei W, Hansen L (2011) Multivariate analysis of flow data in breast lesions and validation in a normal clinical setting. Ultraschall Med 32:511–517PubMedCrossRefGoogle Scholar
  6. 6.
    Svensson WE, Pandian AJ, Hashimoto H (2010) The use of breast ultrasound color Doppler vascular pattern morphology improves diagnostic sensitivity with minimal change in specificity. Ultraschall Med 31:466–474PubMedCrossRefGoogle Scholar
  7. 7.
    Nothacker M, Langer T, Weinbrenner S (2010) Bildgebende Diagnostik in der Onkologie — Evidenzanalysen des Ärztlichen Zentrums für Qualität in der Medizin (ÄZQ) für S3-Leitlinien Z. Evid Fortbild Qual Gesundh Wesen (ZEFQ) 104:554–562CrossRefGoogle Scholar
  8. 8.
    American College of Radiology (2009) Practice guideline for the performance of ultrasound-guided percutaneous breast interventional procedures. Revised 2009 Available at: http:// www.acr.org/SecondaryMainMenuCategories/quality_safety/ guidelines/breast/us_guided_breast.aspxGoogle Scholar
  9. 9.
    American College of Radiology (2009) Practice guideline for the performance of stereotactically guided breast interventional procedures. Revised 2009. Available at: http://www.acr.org/ SecondaryMainMenuCategories/quality_safety/guidelines/ breast/stereotactically_guided_breast.aspxGoogle Scholar
  10. 10.
    Nothacker M, Duda V, Hahn M et al (2009) Early detection of breast cancer: benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review. BMC Cancer 9:335PubMedCrossRefGoogle Scholar
  11. 11.
    Heywang-Köbrunner SH, Schreer I, Heindel et al (2008) Imaging studies for the early detection of breast cancer. Dtsch Arztebl Int 105:541–547PubMedGoogle Scholar
  12. 12.
    Madjar H, Rickard M, Jellins J et al (1999) IBUS guidelines for the ultrasonic examination of the breast. Eur J Ultrasound 9:99–102PubMedCrossRefGoogle Scholar
  13. 13.
    Khouri NF (2009) Breast ultrasound. In: Harris JR et al (eds) Diseases of the breast, 4th edn. Wolter Kluwer, Lippincott Williams & Wilkins, Philadelphia, pp 131–151Google Scholar
  14. 14.
    Mendelson EB, Baum JK, Berg WA et al (2003) Breast Imaging Reporting and Data System, ACR BI-RADS® — Ultrasound, 1st edn, American College of Radiology, RestonGoogle Scholar
  15. 15.
    Madjar H, Ohlinger R, Mundinger A et al (2006) BI-RADSanalogue DEGUM criteria for findings in breast ultrasound — consensus of the DEGUM Committee on Breast Ultrasound. Ultraschall Med 27:374–379PubMedCrossRefGoogle Scholar
  16. 16.
    Wojcinski S, Farrokh A, Weber S et al (2010) Multicenter study of ultrasound real-time tissue elastography in 779 cases for the assessment of breast lesions: improved diagnostic performance by combining the BI-RADS®-US classification system with sonoelastography. Ultraschall Med 31:484–491PubMedCrossRefGoogle Scholar
  17. 17.
    Sadigh G, Carlos RC, Neal CH, Dwamena BA (2011) Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BI-RADS scoring. Breast Cancer Res Treat [Epub ahead of print]Google Scholar
  18. 18.
    Abdullah N, Mesurolle B, El-Khoury M et al (2009) Breast imaging reporting and data system lexicon for US: interobserver agreement for assessment of breast masses. Radiology 25:2665–2672Google Scholar
  19. 19.
    Yoon JH, Kim MH, Kim EK et al (2011) Interobserver variability of ultrasound elastography: how it affects the diagnosis of breast lesions. AJR Am J Roentgenol 196:730–736PubMedCrossRefGoogle Scholar
  20. 20.
    Berg WA, Sechtin AG, Marques H et al (2010) Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am 48:931–987PubMedCrossRefGoogle Scholar
  21. 21.
    Graf O, Helbich TH, Hopf G et al (2007) Probably benign breast masses at US: is follow-up an acceptable alternative to biopsy? Radiology 244:87–93PubMedCrossRefGoogle Scholar
  22. 22.
    Fu CY, Hsu HH, Yu JC et al (2010) Influence of Age on PPV of Sonographic BI-RADS Categories 3, 4, and 5. Ultraschall Med 32:8–13CrossRefGoogle Scholar
  23. 23.
    Moon HJ, Kim MJ, Kwak JY et al (2010). Probably benign breast lesions on ultrasonography: a retrospective review of ultrasonographic features and clinical factors affecting the BIRADS categorization. Acta Radiol 51:375–382PubMedCrossRefGoogle Scholar
  24. 24.
    Moon HJ, Kim MJ, Kwak JY et al (2010) Malignant lesions initially categorized as probably benign breast lesions: retrospective review of ultrasonographic, clinical and pathologic characteristics. Ultrasound Med Biol 36:551–559PubMedCrossRefGoogle Scholar
  25. 25.
    Berg WA, Blume JD, Cormack JB et al (2008) Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 299:2151–2163PubMedCrossRefGoogle Scholar
  26. 26.
    Mundinger A (2006) Staging the breast and axilla. Eur J Cancer Supplements 4:35–37CrossRefGoogle Scholar
  27. 27.
    Lehman CD, DeMartini W, Anderson BO et al (2009) Indications for breast MRI in the patient with newly diagnosed breast cancer. J Natl Compr Canc Netw 7:193–201PubMedGoogle Scholar
  28. 28.
    Cho N, Moon WK, Cha JH et al (2009) Ultrasound-guided vacuum-assisted biopsy of microcalcifications detected at screening mammography. Acta Radiol 50:602–609PubMedCrossRefGoogle Scholar
  29. 29.
    Houssami N, Hayes DF (2009) Review of preoperative magnetic resonance imaging (MRI) in breast cancer: should MRI be performed on all women with newly diagnosed, early stage breast cancer? CA Cancer J Clin 59:290–302PubMedCrossRefGoogle Scholar
  30. 30.
    Turnbull L, Brown S, Harvey I et al (2010) Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial. Lancet 375:563–571PubMedCrossRefGoogle Scholar
  31. 31.
    Peters NH, van Esser S, van den Bosch MA et al (2011) Preoperative MRI and surgical management in patients with nonpalpable breast cancer: the MONET — randomised controlled trial. Eur J Cancer 47:879–886PubMedCrossRefGoogle Scholar
  32. 32.
    Choi YJ, Ko EY, Han BK et al (2009) High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer. Breast 18:119–122PubMedCrossRefGoogle Scholar
  33. 33.
    Houssami N, Ciatto S, Turner RM et al (2011) Preoperative ultrasound-guided needle biopsy of axillary nodes in invasive breast cancer: meta-analysis of its accuracy and utility in staging the axilla. Ann Surg 254:243–251PubMedCrossRefGoogle Scholar
  34. 34.
    Pan L, Han Y, Sun X et al (2010) FDG-PET and other imaging modalities for the evaluation of breast cancer recurrence and metastases: a meta-analysis. J Cancer Res Clin Oncol 136:1007–1022PubMedCrossRefGoogle Scholar
  35. 35.
    Youk JH, Kim EK, Kim MJ et al (2010) Analysis of falsenegative results after US-guided 14-gauge core needle breast biopsy. Eur Radiol 20:782–789PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Alexander Mundinger
    • 1
  1. 1.Radiological Department and Breast CentreNiels-Stensen-ClinicsOsnabrueckGermany

Personalised recommendations