|ECR 2019 / C-1412|
|Added advantage of automated breast ultrasound in the detection of breast lesions in mammographically dense breast|
Thisprospectivestudyincludedatotalof59patientswith64lesionspresentedtotheNCIwithbreastmasses(detectedbyclinicalexaminationorbymammographicexamination.Theiragesrangedfrom24to81years(mean age:41 ± 10 SD years).
Out of 59 patients 64 masses were detected, 36 cases(56.2%) were diagnosed as benign while 28(43.8%) cases were diagnosed as malignant.
Pathological results was used as the gold standard of reference apart from 13 lesions which were proven by to be benign by follow up(BIRADS III to BIRADS II).
Each examination (digital mammography ,ABUS and HHUS) was evaluated regarding the following criteria according to 5th edition of BIRADS lexicon.
I. Digital mammography
As regarding lesions detection 25 lesions (39.1%)out of 64 lesions were not detected by mammography 14(56%) of them were benign and 11 (44%) of the were malignant.
As regarding breast density 44 (68.8%) of breasts examined were ACRC, while 20 (31.2%)were ACR D. No significant correlation in our study between glandular tissue composition breast and malignancy(P value 0.221).
In our study, 24 cases were categorized as BIRADS 0 by mammography due to high breast density(14 of them were benign and 10 were malignant), in 2cases there was malignant masses with no any abnormal criteria at mammography, in 7 cases there was only global asymmetry with no underlying mass by mammography malignant lesions were detected by ABUS and HHUS, in 1case the only suspicious criteria by mammography was focal asymmetry.one case with no abnormal finding at mammography was diagnosed as ADH which is not a malignant mass but categorize the patient as high risk
As regarding lesions detectability it was higher than mammography it could detect 15 lesions missed by mammography, however it was lower than ABUS,ABUS could detect duct papilloma interpreted by HHUS as dilated ducts, and the second lesion was retroarolar lesion interpreted by HHUS as dilated ducts with increased internal vascularity.
As regarding lesions detectability it was highest by ABUS it could detect 17 lesions missed by mammography, and 2 lesions missed by HHUS.
As regarding lesions margins in coronal view (which is unique for ABUS),21(32.8%) lesions showed retraction phenomenon(all were malignant 100%) ,21(32.8%) lesions showed complete hyperechoic rim(19(90.5%) were benign),14(21.9%) lesions showed incomplete(discontinuous) hyperechoic rim(9(64.3%) were benign while 5 (35.7%)were malignant) ,no masses were detected in 8(12.5%) cases. Sensitivity of retraction phenomenon for malignancy was 75%,while specificity was 100%.Specficity of complete hyperechoic rim for benign lesions was 90.5%,,while sensitivity was for benign lesion detection was 52.8%.
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