Diagnostic value of different interpretative criteria in real-time sonography of the breast

Use of breast sonography for clarification of pathological alterations in the breast is continuously increasing. It is known that cystic processes can be distinguished from solid processes with this method. The question of, to what extent, a prognosis of pathological relevance of such processes can be made, is of increased interest. This prognosis of pathological relevance is related to interpretative criteria which are not uniformly defined all over the world and which are also differently applied. The present investigation (evaluation of 755 sonographic focal findings) shows the rating value of each individual appraisal criterion and provides information on the certainty with which malignant and benign lesions in the breast can be distinguished. All interpretative criteria specified have a statistical significant difference (p less than 0.0001, 0.0044) in their rating pattern in malignant and benign processes. The criterion with the highest value is the wall contour. In principle, every sonographic focal finding should be examined with regard to its wall contour, the acoustic attitude of posterior wall, the internal echo pattern and the internal echogenicity. In the dynamic part of the investigation, alterations in the form and structure of the lesion must be registered. In our opinion there is a high probability of distinguishing malignant from benign processes by means of the mentioned criteria.