Echografie is van belang als aanvullend onderzoek bij mammografie

- The results of three years of diagnostic imaging of the breast were evaluated retrospectively, with special attention to the influence of ultrasonography.

In 5245 mammographic investigations, 1841 supplementary ultrasonograms were considered necessary (35). Malignancy of the breast was diagnosed in 250 cases. In 131 female patients the histological diagnosis was preceded by a mammography and supplementary ultrasonography. In 123 patients a lesion suggestive of malignancy could be visualised by ultrasonography (94). The combined sensitivity for detection of malignancy was 97. Specificity was 98. Negative predictive value was almost 100 and the positive predictive value was 78, with an observed prevalence of malignancy of 7.

To assess the additional value of ultrasound the retrospective sensitivity of mammography alone was determined by reviewing the mammograms separate from the ultrasonograms of the malignancy-positive patients. An increase of sensitivity of at least 15 could be attributed to ultrasonography. In 40 of the cases an objective benefit of ultrasonography could be established.

It is concluded that especially in women with palpable lesions whose mammograms are hard to interpret, e.g. young patients with extensive glandular tissue or patients with fibrocystic disease, adenofibrosis or mastopathy, an additional ultrasonogram is indispensable, not only for diagnosis but also for further management of the patient.