Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound

• Published in: Clinical radiology Vol. 60; no. 5; pp. 573 - 578
• Main Authors: Wilkinson, L.S., Given-Wilson, R., Hall, T., Potts, H., Sharma, A.K., Smith, E.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.05.2005; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Axilla; Biological and medical sciences; Biopsy; Breast; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma in Situ - diagnostic imaging; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - surgery; Carcinoma, Lobular - diagnostic imaging; Carcinoma, Lobular - pathology; Carcinoma, Lobular - surgery; Female; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Lymphatic Metastasis; Mammary gland diseases; Mastectomy - methods; Medical sciences; Middle Aged; Multiple primary; Neoplasm Invasiveness; Neoplasms; Neoplasms, Multiple Primary - diagnostic imaging; Neoplasms, Multiple Primary - pathology; Neoplasms, Multiple Primary - surgery; Preoperative Care - methods; Treatment Outcome; Tumors; Ultrasonography, Mammary; Ultrasound; Breast; Multiple primary; Ultrasound; Neoplasms; US; Prognosis; Check; Bilateral; Prevention; Surgery; Primary; Female; Diagnosis; Mammary gland; Woman; Sonography; Human; Multiple; Histology; Breast cancer; Method; Malignant tumor; Case study; Mammary gland diseases; Symptomatology; Clinical management; Treatment; Biopsy; Echography; Radiology; Preoperative; Inaugural sign; Comparative study; Bibliographic review
• DOI: 10.1016/j.crad.2004.10.015
• ISSN: 0009-9260

The aim of this study was to evaluate the contribution of bilateral whole-breast ultrasound (BBUS) to the diagnosis and management of women with newly diagnosed breast cancer. Over a period of 6 months, 102 women presenting with breast cancer underwent BBUS. Data were collected on clinical findings, radiology, histology and surgical outcome. These women were compared with a control group of 124 women presenting over a similar 6-month period 1 year previously, who had undergone targeted breast ultrasound. Multicentric/multifocal tumours were demonstrated in 35 (34%) of the 102 participants and in 18 (15%) of the 124 controls, a statistically significant difference (Fisher's exact test, p=0.001). Multiple tumours were diagnosed preoperatively in 18% of the study population compared with 8% of the controls, and BBUS identified invasive multifocal/multicentric tumours in significantly more women in the study population (11 versus 1 control) (Fisher's exact test, p=0.019). Contralateral cancer was diagnosed in 4 women in the study population and none in the control population (Fisher's exact test, p=0.040). Surgical review showed that the surgical management changed significantly in 8% (95% confidence interval 4 to 14%) of cases in the study population following BBUS. The increase in the number of women undergoing benign biopsies in the study population (10 versus 5 controls) was not statistically significant (Fisher's exact test, p=0.11). BBUS increased the preoperative diagnosis of multiple tumours in women presenting with primary breast cancer, resulting in a management change in 8% of cases.