[Criteria in the evaluation of breast sonography]

The use of sonography to diagnose pathologic changes of the breast is constantly increasing. It is well known that this method can be employed to distinguish cystic from solid processes. Of greater interest is the question as to the usefulness of sonography in prognosticating the pathology of such processes. This prognosis of pathology is linked to assessment criteria which are not uniformly defined worldwide and which are also applied differently. The study reported here--an evaluation of 755 sonographic focal findings--points out the possible distinctiveness of each individual assessment criterion and indicates the degree of confidence with which malignant and benign breast processes can be distinguished. There are statistically significant differences (p less than 0.0001) in the patterns of distinctiveness of all the assessment criteria mentioned depending on whether the processes are malignant or benign. The most important criterion is the edge contour. Every sonographic focus finding should be checked with regard to its edge contour, retrotumorous acoustic behavior, echo structure, and echo density. In the dynamic part of the examination, changes in the form and structure of the finding must be recorded. The authors estimate the changes of being able to distinguish malignant from benign processes on the basis of the above-mentioned criteria as good. The guide to the classification of echographic phenomena presented here may be of help to learners.