[Echomorphology of the breast. Comparative sonographic, radiologic, anatomic and histologic studies of breast...

The interpretation of ultrasound mammograms is complicated by the heterogeneous structure of breast tissue. To improve the diagnostic analysis, a method has been developed which enables us to correlate ultrasound images of mastectomized specimens with the cross-sectional anatomy, the computed tomography, the x-ray photographs of the specimen and the histopathologic study of the corresponding gross serial sections. Some echophenomena considering the propagation properties of ultrasound are discussed. Echodense areas correlate well with inhomogeneous structures of the glandular tissue, i.e. the continuous change of microcystically alterated alveoli, dense and looser connective tissue, dilated ducts and small fat lobules. The histomorphologic equivalent to less echogenic lesions is represented by a homogeneous tissue structure, for example the homogeneous fibrosis of glandular tissue or tumourous tissue. Even fatty tissue appears echopoor. Shadowing phenomena are explained by refraction and absorption effects. The topographic comparison of echograms with identical x-ray photographs of specimen slices emphasizes that the sonographic examination of the breast can enhance the radiographic findings and therefore improve the diagnostic accuracy.