Breast ultrasound in office gynecology--ten years of experience

Mammography in screening or on indication is regarded as the gold standard for breast examination to detect breast cancer. The present study was performed to evaluate breast ultrasound examination (BU) as a supplement to physical breast examination in a gynecological office setting.

BU was performed concomitantly with all physical breast examinations in a gynecological clinic. The results of all BUs during a 10-year period using the patients' personal numbers were crossed with the Danish Cancer Registry and the Danish Pathology Data Bank. All new breast malignancies registered from the date of BU and 12 months later were included.

A total of 3030 BUs of both breasts was performed in 1428 women. Twenty-eight new breast malignancies were registered in 27 patients. Physical examination did not reveal any tumors not detected by ultrasound. Sixteen of the 28 malignancies were non-palpable (57 %). BU detected 25 of these malignancies, thus yielding a sensitivity of 89 %. Mammography performed within 12 months of the diagnosis was negative in 11 patients resulting in a rate of 44 % of malignancies with a negative mammography result. The tumors measured an average of 11 mm (range 4 - 30 mm) using the largest diameter.

BU offers substantial help for the detection of breast cancer. The sensitivity is high, and in a gynecological setting where ultrasound is used for almost every consultation, it is natural to use the scanner for the breast examination. Larger studies with evaluation of interobserver variability for tumor detection by ultrasound are needed.