Benign breast lesions: ultrasound detection and diagnosis

Experience with 2500 patients over age 30 studied by physical examination, x-ray mammography, and sonography enabled definition of several specific clinical situations in which sonography adds meaningful diagnostic information not provided by either of the other examinations. These include: palpable breast masses for cyst-solid differentiation; nonpalpable mammographic masses for cyst-solid differentiation; and women with a symptomatic area in the breast that shows only uniformly dense fibro-glandular tissue on x-ray mammograms. For women with radiographically dense breasts who have no breast symptoms, abnormal physical findings, or mammographic lesions, sonography will identify many benign cysts and also some benign solid lesions, but at best only rarely (none of the 587 cases in this study) will it detect an otherwise occult breast cancer. Our data suggest that sonography should not be a substitute for physical examination and mammography in women over age 30, but rather that in three specific clinical situations it can be a valuable addition to the standard diagnostic evaluation.