Benefit of Ultrasonography in the Detection of Clinically and Mammographically Occult Breast Cancer

• DOI: 10.1007/s00268-007-9273-2
• Publication Date: 2007-10-24T11:50:43Z
• Authors: Sharon W. W. Chan; Polly S. Y. Cheung; Stefanie Chan; Suk Sze Lau; Ting Ting Wong; Michael Ma; Ada Wong; Yuen Ching Law
• Keywords: Occult; Vascular surgery; Cardiothoracic surgery

AbstractObjectiveThe purpose of this study was to evaluate the performance of high‐resolution ultrasonography in the detection of clinically and mammographically occult breast cancer.Materials and methodsFrom September 2003 to November 2006, a total of 1485 patients were confirmed to have in situ or invasive breast cancer in Hong Kong Sanatorium and Hospital Breast Care Centre. All patients underwent mammography (MMG) and/ or sonography (USG) evaluation. Patients’ age and size of tumor detected by USG alone were compared with those detected by MMG.ResultsAltogether, 222 patients (17%) had positive imaging findings on USG only, among which 22 (13%) patients had nonpalpable tumors. Performing USG increased the cancer detection rate among clinically and mammographically occult breast lesions by 14.3%. The mean size of the tumors detected only by USG was 1.98 cm, which was not significantly different from the mean size of tumor detected by MMG (1.46) (p = 0.23). This remains true in the group of patients with nonpalpable tumors (1.36 vs. 1.46 cm, p = 0.88). The sensitivity of USG is 91%, which is significantly higher than that of MMG (78%) (p = 0.001). This remains true in patients age <40 or ≥40, tumor grading I toIII, and LVI +/− cases. However, MMG had higher sensitivity in the group of patients with nonpalpable tumors (73% vs. 62%, p = 0.01) and noninvasive cancers (72% vs. 69%, p = 0.01).ConclusionsThe use of high‐resolution USG may lead to detection of a significant number of occult cancers that are no different in size from nonpalpable mammographically detected lesions.