High-resolution breast ultrasonography

Recent improvements in ultrasonic-scanning now permit solid tumors in the breast as small as 5 mm and cystic lesions of 2mm in size to be detected. The overall accuracy of diagnostic ultrasound is very high, and as more experience is gained by application of newer high-resolution systems this accuracy will improve even further. In certain cases, ultrasonography can detect lesions completely missed by clinical palpation. In some areas such as cystic lesions this modality is far superior to the mammograph and in other situations it complements other diagnostic procedures. Areas of microcalcification may be localized. Cystic lesions of the breast are not easily diagnosed with great accuracy. In our extensive experience over the past 4 years, fibroadenomas generally appear as sharply marginated spherical or lobulated masses with an echopoor center and high through transmission. Carcinoma tends to attenuate sound energy highly and frequently produces a characteristic echo pattern. Fibrous dysplasia appears as a highly echogenic zone which is readily distinguished from other entities. Contact ultrasonography is used to localize the lesion three-dimensionally within the breast for biopsy purposes and to detect the presence of distant metastases.