Breast sonography
The breast ultrasound is the ultrasound examination of the breast . It is an imaging process in which the breast is shown in a sectional image process . Like mammography, breast ultrasound is an apparatus-based procedure for screening and diagnosing benign and malignant changes in breast tissue.
Areas of application
The primary use of sonography is recognized for women under 40 years of age. The supplementary use in the case of unclear mammographic findings and high mammographic density is also guaranteed. Breast ultrasonography is also indicated for women and men with a palpable finding or chest pain, and for nipple discharge. Fine-needle biopsies and punch biopsies are also performed under ultrasound in order to take specific tissue samples for histological examination.
Primary screening
Like the other procedures, breast ultrasound can be used for the early detection of breast cancer . Sonography has advantages over mammography in women with a high proportion of glands (high density), and thus also in women before menopause . Breast ultrasonography should also be used as the first imaging method for women during pregnancy and breastfeeding , as it does not involve any radiation exposure and is uncomplicated to use after the palpation examination.
There is some dispute about screening using breast ultrasound as an early detection examination comparable to mammography screening. The lack of large randomized or prospective studies and problems of quality assurance are criticized here. On the other hand, there are increasing numbers of non-randomized studies with very encouraging results. Basically, no single breast imaging method can detect every breast cancer. The sensitivity of sonography is probably higher for (invasive) carcinoma than that of mammography. Pre-stages of invasive carcinoma ( DCIS ), insofar as they are characterized by the formation of microcalcifications , are better discovered through mammography.
Secondary screening
In addition to mammography, an ultrasound scan is used, especially if the breast is dense.
differentiation
Diagnostic differentiation through sonography goes beyond the distinction between cystic and solid findings by differentiating solid lesions into benign, probably benign, suspicious and highly suspicious ( BIRADS classification). In addition to the internal echo pattern ( echogenicity ), the edge structures of a focus finding are particularly relevant here.
technology
Today, breast ultrasound uses high-resolution broadband linear probes with a frequency between 2 and 17 MHz. Additional technical developments to the B-scan for the purpose of differentiating between benign and malignant are color Doppler sonography for the representation of the blood vessel supply, the 3D-ultrasound with its additional plane (C-plane) and the elastography with the color coding of the tissue stiffness .
Individual evidence
- ↑ Rumack CM, Wilson SR, Charboneau JW, Levine D Diagnostic Ultrasound 2011 ISBN 978-0-323-05397-6 , page 733
- ↑ Schulz KD, Albert US Level 3 Guideline, Breast Cancer Early Detection (PDF; 2.3 MB) 2008, page 127
- ↑ Rumack CM, page 785
- ↑ Rumack CM, page 817
- ↑ Rumack CM, page 833
- ↑ Kolb TM et al. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: An analysis of 27,825 patient evaluations ( Memento of the original from August 4, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and still Not checked. Please check the original and archive link according to the instructions and then remove this notice. . In: Radiology 2002; 225: 165-175 PMID 12355001 .
- ↑ Corsetti V et al .: Breast screening with ultrasound in women with mammography-negative dense breasts: Evidence on incremental cancer detection and false positives, and associated cost . In: European Journal of Cancer , 2008 PMID 18267357 .
- ↑ Berg WA et al .: Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer ( page no longer available , search in web archives ) Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. , Radiology 2004; 233: 830-849 PMID 15486214 .
- ^ Benson SR et al .: Ultrasound is now better than mammography in detection of invasive breast cancer. In: The American Journal of Surgery 2004; 31: 289-295 PMID 15474430
- ↑ Rumack CM, page 773
- ↑ Madjar H et al. BI-RADS analogue DEGUM criteria for ultrasound findings of the breast - consensus of the DEGUM Breast Sonography Working Group . In: Ultrasound in Med 2006; 27: 374-79 PMID 16927216 .
