PURPOSE: To compare 3D ultrasound (3D-US) with 2D ultrasound (2D-US) in terms of their usefulness and limitations in the diagnosis of breast masses. MATERIALS AND METHODS: We obtained 2D and 3D US images of 37 breast lesions present in 20 cases of fibroadenoma, nine of cancer, and eight of fibrocystic disease proven in a total of 26 cases [fibroadenoma (n=13), breast cancer (n=9), fibrocystic disease (n=4)] by histologic examination, and by clinical evaluation and clinical evaluation with sonographic imaging in eleven. When comparing 3D and 2D-US images we had no prior information regarding detection rate according to the size of lesions, whether or not internal and boundary echo patterns could be interpreted, accurate differentiation between tumorous and non-tumorous lesions, or the accuracy with which benign and malignant tumors could be differentiated. RESULTS: For lesions of 1 cm or less in diameter the detection rate of 3D-US was lower than that of 2D-US, but for lesions over 1 cm there was no difference between the two modalities. In fibroadenoma and breast cancer, 3D-US was more useful than 2D-US for the evaluation of both internal and boundary echo, but with fibrocystic disease and in the diagnosis of tumor/non-tumor, there was no significant difference. In breast cancer, however, 3D-US more accurately determined malignancy, and in fibroadenoma, because of the pseudospicule revealed by 3D-US, this modality was less exact in determining benignancy. CONCLUSION: In the evaluation of internal and boundary echo in breast mass diagnosis, 3D-US was more useful than its 2D counterpart. For lesions of 1 cm or less in diameter, however, the detection rate of 3D-US was low, and since in some benign cases a pseudospicule was apparent, the possibiliy of confusion with malignancy arose. For these reasons, the usefulness of 3D-US was limited.
Breast Neoplasms ; Breast* ; Diagnosis* ; Fibroadenoma ; Ultrasonography

PURPOSE: The objective of our study was to compare the value of differential diagnosis of ultrasonography with power Doppler imaging(PDI) and 99mTc-MIBI scintimammography in the evaluation of breast lesions. MATERIALS AND METHODS: Fifty-five breast lesions in 48 patients underwent both 99mTc-MIBI scintimammography and sonography with PDI. Lesions were classified as benign or malignant on the basis of the absence or presence of a focus of increased activity at scintimammography, and the shape, border, echogenicity and amount of flow at sonography. The accuracy of the two modalities according to tumor size was compared. RESULTS: Pathologic diagnosis showed that among the 55 lesions, 40 were malignant and 15 were benign. In the detection of breast cancer, sensitivities and specificities were 97.5%(39/40) and 66.7%(10/15) for ultrasonography with PDI and 72.5%(29/40) and 86.7%(13/15) for scintimammography. For 32 lesions smaller than 2 cm, sensitivities and specificities were 94.7%(18/19) and 61.5%(8/13) for ultrasonography with PDI and 57.9%(11/19) and 84.6%(11/13) for scintimammography. For 23 lesions 2 cm or larger, these parameters were 100%(21/21) and 100%(2/2) for ultrasonography with PDI and 85.7%(18/21) and 100%(2/2) for scintimammography. CONCLUSION: In the diagnosis of breast cancer, ultrasonography with PDI was less specific than 99mTc-MIBI scintimammography. Ultrasonography with PDI was, however, more sensitive than 99mTc-MIBI scintimammography, particularly for lesions smaller than 2 cm.
Breast Neoplasms ; Breast* ; Diagnosis ; Diagnosis, Differential ; Humans ; Ultrasonography*

Authors retrospectively analyzed ultrasonographic findings of 12 cases of breast carcinomas which were proven pathologically at Yeungnam University Hospital from March 1992 to August 1992. Classically, breast carcinomas were described as irregular and lobulated hypoechoic solid masses with inhomogeneous internal echoes and frequent attenuation of the sound beam. And other additional ultrasonographic findings were echogenic rim, disruptions of superficial layer, microcalcification, skin thickening and so on. In our studies, not all of these findings of breast carcinomas were found in each case, but most of these findings were noted. However, several studies have demonstrated considerable overlap in the ultrasonographic appearance of benign lesions and carcinoma. Thus, accurate sonographic determination of the type of solid mass is not possible with current ultrasonographic imaging techniques and criteria. For more accurate diagnosis of breast lesions, sonographic and other imaging techniques are interpreted together.
Breast Neoplasms* ; Breast* ; Diagnosis ; Retrospective Studies ; Skin ; Ultrasonography

Breast ultrasound and mammography are established procedures for the diagnosis of breast masses while new technology is opening the door for early cancer diagnosis. The limitation of ultrasound and mammography is that they are only based on physical properties. Recently, using a color doppler system, detection of color flow signal and a resistance index that depend on the blood flow and the blood velocity was applied for diagnosis of breast malignancy. Sixty-five patients admitted for breast surgery were studied. The final diagnosis was made by pathology for thirty malignancies and thirty-five benign lesions. The color doppler measurements on the breast lesions were made preoperatively. The following parameter were assessed :flow velocity, color signal grade and resistance index. The results are as follows: 1) Color signals were detected in twenty-four of the thirty malignancies and in seven of thirty-five benign lesions. 2) Malignant lesions showed a significantly higher maximum velocity (mean=12.52 cm/sec vs 6.34 cm/sec). 3) The resistance index values in the malignancies was higher compared to that in the benign lesions (P < 0.01), a cutoff point 0.6 was used. 4) The color signal grade was grade 0 and I in thirty-four cases of the benign breast lesions (97%) and grade II and III in fifteen of the malignant breast lesions (50%). 5) In breast cancer, the color signal was detected more often in large masses above 2 cm is size,but the result was not statistically significant (P > 0.05). Color doppler flow examination is a useful method for evaluation of benign and malignant breast lesions.
Breast Neoplasms* ; Breast* ; Diagnosis* ; Humans ; Mammography ; Pathology ; Ultrasonography

PURPOSE: To compare the feasibility of 9 9 mTc-MIBI scintimammography as a tumor localizing agent in breast lesions in comparison with that of mammography and ultrasonography, and to evaluate the efficacy of these three modalities. MATERIALS AND METHODS: Sixty-four breast lesions were classified as benign or malignant on the basis of sono-graphic and mammographic criteria and were further analyzed by means of 99mTc-MIBI scintimammography. The classifications thus obtained were compared with the biopsy findings, and in order to compare the three techniques, the sensitivity, specificity, accuracy, and negative and positive predictive values were calculated for each individual modality. RESULTS: Of 64 histologically proven lesions, 33 were malignant and 31 were benign. Sensitivities and specificities for malignancy were 86.2% and 64.5% for mammography, 87.9% and 76.7 % for sonography, and 78.8% and 74.2% for 99mTc-MIBI scintimammography. CONCLUSION: Mammography and ultrasonogrphy are reliable diagnostic modalities for the detection of breast cancer. 99mTc-MIBI scintimammography has a higher specificity than mammography and it may help to reduce unnecessary biopsies.
Biopsy ; Breast Neoplasms* ; Breast* ; Classification ; Diagnosis* ; Mammography* ; Sensitivity and Specificity ; Ultrasonography*

Tumor vascularity is an important indicator for differential diagnosis, tumor growth, and prognosis. Superb micro-vascular imaging (SMI) is an innovative ultrasound technique for vascular examination that uses a multidimensional filter to eliminate clutter and preserve extremely low-velocity flows. Theoretically, SMI could depict more vessels and more detailed vascular morphology, due to the increased sensitivity of slow blood flow. Here, we report the early experience of using SMI in 21 breast cancer patients. We evaluated tumor vascular features in breast cancer and compared SMI and conventional color or power Doppler imaging. SMI was superior to color or power Doppler imaging in detecting tumor vessels, the details of vessel morphology, and both peripheral and central vascular distribution. In conclusion, SMI is a promising ultrasound technique for evaluating microvascular information of breast cancers.
Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Humans ; Prognosis ; Ultrasonography*

BACKGROUND: The purpose of this study was to determine the accuracy and the reliability in diagnosing breast cancer. METHODS: This clinical study was performed on 132 patients with palpable breast masses who had been diagnosed with excisional biopsy from August 1997 to July 1998 at the Department of Surgery, Seoul Adventist Hospital. Among the 132 patients, the mammographs were taken for 65 patients, ultrasonographs for 83 patients, and fine needle aspiration biopsies (FNAB) for 72 patients. The results of the three diagnostic procedures were compared with the postexcisional histologic diagnosis. RESULTS: 1) Mammography discovered breast cancer with an accuracy of 70.8%, a false positive fraction of 6.8%, a false negative fraction of 76.2%, a sensitivity of 23.8%, a specificity of 93.2%, and a positive predictive value of 62.5%. 2) Ultrasonography detected breast cancer with an accuracy of 74.7%, a false positive fraction of 6.9%, a false negative fraction of 68.0%, a sensitivity of 32.0%, a specificity of 93.1%, and a positive predictive value of 66.7%. 3) Among the 72 aspirates, 7 (9.7%) aspirates had a technically unsatisfactory aspiration cytology. 4) Of the 65 technically satisfactory cytologies, the diagnosis was malignant in 16 cases, suspicious for malignancy in 6 cases, and benign in 43 cases. 5) Aspiration cytology detected breast cancer with an accuracy of 90.8%, a false positive fraction of 4.9%, a false negative fraction of 16.7%, a sensitivity of 83.3%, a specificity of 95.1%, and a positive predictive value of 90.9%. CONCLUSIONS: The fine needle aspiration biopsy was more reliable than either mammography or ultrasonography. Also, as an initial diagnostic method, fine needle aspiration biopsy had a high degree of accuracy in diagnozing palpable breast masses.
Biopsy* ; Biopsy, Fine-Needle* ; Breast Neoplasms* ; Breast* ; Diagnosis* ; Humans ; Mammography* ; Sensitivity and Specificity ; Seoul ; Ultrasonography ; Ultrasonography, Mammary*

The history of the radiological examination of the breast has been long, and recently the methods forexamining the breast are variable: mammography, thermography, xeroradiography, ultrasonography, water-pathsonography, transillumination, mammary C.T., M.R. Imaging, infra-red scanning, nuclear medicine, andgalactography. Most of these methods were not proven or have not been satisfied on their clinical testing butconventional mammography has been the gold standard for diagnosis of the breast cancer and no other method hasreached its effectiveness. The authors performed mammography in 488 patiens with breast abnormalities who hadvisited to Yeung Nam University hospital form May, 1983 to Dec. 1984. And we analyzed the mammographic findingsand diagnostic accuracy in pathologically confirmed 53 cases by operations or biopsies. The results are asfollows: 1. Among 16 cases of breast malignancies, (1) the most prevalent age group is 6th decade(37.5%), followedby 5th decade(31.3%), (2) the most common pathologic type is ductal carcinoma(93.75%), (3) the masses are largerthan 2cm, in 8 cases, smaller than 2cm. in 5 cases, and no visible mass is observed in 3 cases. 2. Among 37 casesof benign breast diseases, (1) the most prevalent age group is 4th & 5th decades(each11 cases), and followed by3rd decade(8 cases), (2) the most common disease is benign tumor (17 casees), followed by fibrocystic dysplasia(13cases), and inflammating disease(7 cases). (3) radiologically visible masses are observed in 16 cases and themasses are smaller than 2cm. in 11 cases. 3. the diagnostic accuracy of mammography compared with that ofpathology, (1) in malignancy, the accuracy rate is 75%(12/16 cases), and 87%(32/37 cases) in benign diseases. (2)avearage accuracy rate is 81%(44/53 cases).
Biopsy ; Breast Diseases ; Breast Neoplasms ; Breast ; Diagnosis ; Humans ; Mammography ; Methods ; Nuclear Medicine ; Thermography ; Transillumination ; Ultrasonography ; Xeroradiography

An imaging-guided core needle biopsy has been proven to be reliable and accurate for the diagnosis of both benign and malignant diseases of the breast, and has replaced surgical biopsy. However, the possibility of a false-negative biopsy still remains. Imaging-pathology correlation is of critical importance in imaging-guided breast biopsies to detect such a possible sampling error and avoid a delay in diagnosis. We will review five possible categories and corresponding management after performing an imaging-pathology correlation in a sonography-guided core needle biopsy of a breast lesion, as well as illustrate the selected images for each category in conjunction with the pathologic finding. Radiologists should be familiar with the imaging features of various breast pathologies and be able to appropriately correlate imaging findings with pathologic results after a core needle biopsy.
*Biopsy, Needle ; Breast Neoplasms/*pathology/ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Risk Assessment ; *Ultrasonography, Interventional ; *Ultrasonography, Mammary

We report the sonographic features of an intracystic papillary carcinoma of the breast presenting as recurrent hemorrhagic cysts following trauma. A 56-year-old woman presented with palpable breast masses after a traumatic event; sonography showed multiple, well-defined, hemorrhagic cysts. Hemorrhagic fluid was evacuated by fine needle aspiration with no residual lesions. Cytology was negative for malignancy. Five months later, the mass reappeared; sonography demonstrated multiple cysts with solid nodules. US-guided core biopsy and surgery revealed invasive papillary carcinoma. We suggest close follow-up of cystic masses, even with negative cytology, and performance of surgical excisional biopsy in cases of rapid refilling after aspiration.
Ultrasonography, Mammary/methods ; Recurrence ; Middle Aged ; Mammography/methods ; Lymphatic Metastasis ; Humans ; Hemorrhage/*diagnosis/ultrasonography ; Female ; Diagnosis, Differential ; Cysts/*diagnosis/ultrasonography ; Carcinoma, Papillary/*diagnosis/ultrasonography ; Breast Neoplasms/*diagnosis/ultrasonography