Role of ultrasound and ultrasound guided biopsy in the evaluation of mammographically proved breast calcifications

Document Type : Research project

Authors

1 Radiology Department, Faculty of Medicine, Alexandria University, Egypt

2 Radiology Department, Faculty of medicine, Alexandria University, Egypt

3 Pathology Department, Faculty of Medicine, Alexandria University, Egypt

Abstract

Abstract:
Objective: To evaluate the ability of sonography to depict and guide biopsies of mammographically suspicious microcalcifications and to reveal the mammographic features and histologic outcomes of lesions amenable to sonographically guided biopsy
Methods: The study was conducted on 30 patients referred to the Radiology Department at Alexandria Main University Hospital for assessment of sensible breast lumps or screening mammogram with accidentally discovered breast lesions. Each patient was subjected to full history taking ,clinical examination ,laboratory investigation e.g. bleeding time, mammography and ultrasound. Lesions visible on sonography subsequently underwent sonographically guided percutaneous core biopsy while lesions were not depicted on sonography were sent for mammographically guided wire localization with surgical excision.
Results: In 26 cases, there were sonographically visible microcalcifications which seen on the background of associated hypoechoic masses or area of sonographically distorted parenchyma. The associated lesions were smaller in size in comparison with the corresponding mammographic abnormality in 64%.
Calcifications were seen as tiny strongly echogenic non shadowing foci.
All sonographically visible calcific foci were less in their number than in mammogram.
The larger the cluster size, the more visible sonographically, 100% of clusters equal or more than 2 cm long were sonographically visible.
Conclusion: Targeted US is an effective method for the characterization of microcalcifications. Ultrasound sensitivity for breast density categories III and IV is higher than the mammographic sensitivity. Visibility of malignant microcalcifications improves when the size of the clustered microcalcifications is greater than 10 mm.

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