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DOI: 10.1055/s-0029-1245426
© Georg Thieme Verlag KG Stuttgart · New York
Breast Ultrasound in Office Gynecology – Ten Years of Experience
Ambulante Mammasonografie: 10 Jahre ErfahrungPublication History
received: 9.8.2009
accepted: 7.4.2010
Publication Date:
11 October 2010 (online)
Zusammenfassung
Ziel: Die Mammografie gilt als Goldstandard sowohl als Screeningmethode als auch bei Malignitätsverdacht zur Detektion von Brustkrebs. Ziel dieser Untersuchung war die Bewertung der Mammasonografie (BU) in Ergänzung zur Mamma Palpation in einer gynäkologischen Ambulanz. Material und Methoden: BU wurde ergänzend zu allen Mamma Palpationsuntersuchungen in einer gynäkologischen Ambulanz durchgeführt. Die Ergebnisse aller BUs einer 10 Jahres-Periode wurden mittels der Personalnummer der Patientinnen mit dem dänischen Krebsregister und der dänischen Pathologie Datenbank korreliert. Alle neu diagnostizierten Mammakarzinome vom Zeitpunkt der BU bis zu 12 Monate danach wurden eingeschlossen. Ergebnisse: Insgesamt wurden 3030 BU beider Mammae an insgesamt 1428 Frauen durchgeführt. Achtundzwanzig Mammakarzinome wurden bei 27 Patientinnen diagnostiziert. Mittels Palpation wurde kein Karzinom erfasst, welches nicht auch mit der BU detektiert wurde. Sechzehn der 28 Karzinome waren nicht palpabel (57%), BU detektierte 25/28 Karzinomen, was einer Sensitivität von 89% entspricht. Die Mammografie, die binnen 12 Monaten der Diagnosestellung durchgeführt wurde, war negativ bei 11 Patientinnen, was einer Rate von 44% nicht mittels Mammografie detektierten Karzinomen entspricht. Die Tumoren hatten im Mittel einen maximalen Durchmesser von 11 mm (4-30mm). Schlussfolgerung: BU erwies sich als substanzielle Hilfe zur Detektion von Mammakarzinomen. Die Sensitivität ist hoch und im Rahmen gynäkologischer Untersuchungen, bei denen nahezu immer Ultraschall eingesetzt wird, ist es nur natürlich, die Sonografie genauso zur Brustuntersuchung nutzen. Größere Untersuchungen zur Evaluation der Intraobservervariabilität Variabilität in der Detektion von Mammatumoren mittels Ultraschall müssen durchgeführt werden.
Abstract
Purpose: Mammography in screening or on indication is regarded as the gold standard for breast examination to detect breast cancer. The present study was performed to evaluate breast ultrasound examination (BU) as a supplement to physical breast examination in a gynecological office setting. Materials and Methods: BU was performed concomitantly with all physical breast examinations in a gynecological clinic. The results of all BUs during a 10-year period using the patients’ personal numbers were crossed with the Danish Cancer Registry and the Danish Pathology Data Bank. All new breast malignancies registered from the date of BU and 12 months later were included. Results: A total of 3030 BUs of both breasts was performed in 1428 women. Twenty-eight new breast malignancies were registered in 27 patients. Physical examination did not reveal any tumors not detected by ultrasound. Sixteen of the 28 malignancies were non-palpable (57 %). BU detected 25 of these malignancies, thus yielding a sensitivity of 89 %. Mammography performed within 12 months of the diagnosis was negative in 11 patients resulting in a rate of 44 % of malignancies with a negative mammography result. The tumors measured an average of 11 mm (range 4 – 30 mm) using the largest diameter. Conclusion: BU offers substantial help for the detection of breast cancer. The sensitivity is high, and in a gynecological setting where ultrasound is used for almost every consultation, it is natural to use the scanner for the breast examination. Larger studies with evaluation of interobserver variability for tumor detection by ultrasound are needed.
Key words
breast - screening - ultrasound - malignancy
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Dr. Suzan Lenz
Gynecologic Clinic
Hyldegaardsvej 4
2920 Charlottenlund
Denmark
Phone: ++ 45/20 78 51 44
Fax: ++ 45/39 63 91 13
Email: suzanlenz@dadlnet.dk