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DOI: 10.1055/a-1634-5021
Best Practice Guideline – DEGUM Recommendations on Breast Ultrasound
Part I – Examination technique, DEGUM ultrasound criteria, and documentation Article in several languages: English | deutsch![](https://www.thieme-connect.de/media/ultraschall/202206/lookinside/thumbnails/uim-3726_10-1055-a-1634-5021_en-1.jpg)
Abstract
For many years, breast ultrasound has been used in addition to mammography as an important method for clarifying breast findings. However, differences in the interpretation of findings continue to be problematic [1] [2]. These differences decrease the diagnostic accuracy of ultrasound after detection of a finding and complicate interdisciplinary communication and the comparison of scientific studies [3]. In 1999, the American College of Radiology (ACR) created a working group (International Expert Working Group) that developed a classification system for ultrasound examinations based on the established BI-RADS classification of mammographic findings under consideration of literature data [4]. Due to differences in content, the German Society for Ultrasound in Medicine (DEGUM) published its own BI-RADS-analogue criteria catalog in 2006 [3]. In addition to the persistence of differences in content, there is also an issue with formal licensing with the current 5th edition of the ACR BI-RADS catalog, even though the content is recognized by the DEGUM as another system for describing and documenting findings. The goal of the Best Practice Guideline of the Breast Ultrasound Working Group of the DEGUM is to provide colleagues specialized in senology with a current catalog of ultrasound criteria and assessment categories as well as best practice recommendations for the various ultrasound modalities.
Publication History
Received: 07 April 2021
Accepted: 02 September 2021
Article published online:
17 December 2021
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References
- 1 Stavros AT, Thickmann D, Rapp CL. et al. Solid breast nodules: use of sonography to distinguish between benign and malignant nodules. Radiology 1995; 196: 123-134 DOI: 10.1148/radiology.196.1.7784555.
- 2 Ohlinger R, Klein GM, Köhler G. Mamma-Sonographie – Wertigkeit sonographischer Dignitätskriterien für die Differenzialdiagnose solider Herdbefunde. Ultraschall in Med 2004; 25: 48-53 DOI: 10.1055/s-2003-45244.
- 3 Madjar H, Ohlinger R, Mundinger A. et al. BI-RADS analoge DEGUM Kriterien von Ultraschallbefunden der Brust – Konsensus des Arbeitskreises Mammasonographie der DEGUM. Ultraschall in Med 2006; 27: 374-379 DOI: 10.1055/s-2006-926943.
- 4 American College of Radiology (ACR). ACR-BI-RADS® – Ultrasound. In: ACR Breast Imaging Reporting and Data System. Breast Imaging Atlas. In: Reston VA (Hrsg)2003; American College of Radiology.
- 5 Corsetti V, Houssami N, Ferrari A. et al. Breast screening with ultrasound in women with mammographic-negative dense breasts: evidence on incremental cancer detection and false positives and associated cost. Eur J cancer 2008; 44: 539-544 DOI: 10.1016/j.ejca.2008.01.009.
- 6 Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 2002; 225: 165-175 DOI: 10.1148/radiol.2251011667.
- 7 Gießelman K. Über die Dichte spricht man nicht. Deutsches Ärzteblatt 2015; 1118-1119
- 8 Müller-Schimpfle MP, Brandenbusch VC, Degenhardt F. Zur Problematik der dichten Brust – AK Mamamsonografie der DEGUM. Senologie 2016; 13: 76-81
- 9 Interdisziplinäre S3-Leitlinie Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms. Langversion 0.4.0 2017; AWMF-Registernummer:032-045OL.
- 10 Mundinger A, Bader W. Rolle der Sonografie bei der Früherkennung des Mammakarzinoms. TumorDiagn u Ther 2019; 40: 417-424
- 11 Girardi V, Tonegutti M, Ciatto S. et al. Breast ultrasound in 22,131 asymptomatic women with negative mammography. Breast 2013; 22: 806-809 DOI: 10.1016/j.breast.2013.02.101.
- 12 Berg WA, Bandos AI, Mendelson EB. et al. Ultrasound as the Primary Screening Test for Breast Cancer: Analysis From ACRIN 6666. J Natl Cancer Inst 2015; 108: djv367 DOI: 10.1093/jnci/djv367.
- 13 Ohuchi N, Suzuki A, Sobue T. et al. Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomised controlled trial. Lancet 2016; 387: 341-348 DOI: 10.1016/S0140-6736(15)00774-6.
- 14 Madjar H. Sonoanatomie der Brust. In Kursbuch Mammasonographie Ein Lehratlas nach Richtlinien der DEGUM und der KBV. 3., komplett aktualisierte Auflage. Stuttgart. New York.: Georg Thieme Verlag; 2012: 47-54
- 15 Gabrielson M, Chiesa F, Behmer C. et al. Association of reproductive history with breast tissue characteristics and receptor status in the normal breast. Breast Cancer Res Treat 2018; 170: 487-497 DOI: 10.1007/s10549-018-4768-0.
- 16 Olsson H, Jernström H, Alm P. et al. Proliferation of the breast epithelium in relation to menstrual cycle phase, hormonal use and reproductive factors. Breast Cancer Res Treat 1996; 40: 187-196 DOI: 10.1007/BF01806214.
- 17 Soliman AT, De Sanctis V, Yassin M. Management of Adolescent Gynecomastia: An Update. Acta Biomed 2017; 88: 204-213 DOI: 10.23750/abm.v88i2.6665.
- 18 Gruber I, Hahn M, Fehm T. et al. Relevance and methods of interventional breast sonography in preoperative axillary lymph node staging. Ulltraschall Med 2012; 33: 337-343 DOI: 10.1055/s-0031-1273317.
- 19 Choi YJ, Ko EY, Han BK. et al. High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer. Breast 2009; 18: 119-122 DOI: 10.1016/j,breast.2009.2.004.
- 20 Wang RY, Zhang YW, Gao ZM. et al. Role of sonoelastography in assessment of axillary lymph nodes in breast cancer: a systemic review and metaanalysis. Clin Radiol 2020; 75: 320.e1-320.e7 DOI: 10.1016/j.crad.2019.11.016.
- 21 Lin X, An X, Xiang H. et al. Ultrasound Imaging for Detecting Metastasis to Level II and III Axillary Nodes after Axillary Lymph Node Dissection for Invasive Breast Cancer. J Ultrasound Med 2019; 38: 2925-2934 DOI: 10.1002/jum.14998.
- 22 Qiu SQ, Aarnink M, van Maaren MC. et al Validation and update of a lymph node metastasis prediction model for breast cancer. Eur J Surg Oncol 2018; 44: 700-707 DOI: 10.1016/j.ejso.2017.12.008. . Epub 2018 Jan 17.; PMID: 29449047
- 23 Steinkamp HJ, Beck A, Werk M. et al. Kapseldurchbrüche zervikaler Lymphknotenmetastasen: Diagnostischer Stellenwert der Sonographie. Ultraschall in Med 2003; 24: 323-330 DOI: 10.1055/s-2003-42914.
- 24 Mueller-Schimpfle MP, Brandenbusch VC, Degenhardt F. et al. The Problem of Mammographic Breast Density – The Position of the DEGUM Working Group on Breast Ultrasound. Ultraschall in Med 2016; 37: 170-175 DOI: 10.1055/s-0041-108004.
- 25 Müller-Schimpfle M. et al. Diskussionspapier – BI-RADS die 5. – eine Kurzmitteilung aus deutsch-/österreichischer Sicht. Geburtshilfe Frauenheilkd 2016; 76: 490-496
- 26 Hrsg. American College of Radiology. ACR BI-RADS® Atlas der Mammadiagnostik. Richtlinien zur Befundung, Managementempfehlungen und Monitoring. Deutsche Übersetzung der 5. Englischen Auflage, 2013 Berlin. Heidelberg: Springer Verlag; 2016
- 27 Mendelson EB, Böhm-Velez M, Berg WA. et al. ACR BI-RADS® – Ultrasound. In ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013.
- 28 Gruber I, Oberlechner E, Heck K. et al. Percutaneous Ultrasound-Guided Core Needle Biopsy: Comparison of 16-Gauge versus 14-Gauge Needle and the Effect of Coaxial Guidance in 1065 Breast Biopsies – A Prospective Randomized Clinical Noninferiority Trial. Ultraschall in Med 2020; 41: 534-543 DOI: 10.1055/a-1014-2628.
- 29 Hahn M, Krainick-Strobel U, Toellner T. et al. Interdisciplinary consensus recommendations for the use of vacuum-assisted breast biopsy under sonographic guidance: first update 2012. Ultraschall in Med 2012; 33: 366-371 DOI: 10.1055/s-0032-1312831.
- 30 Hoffmann J, Marx M, Hengstmann A. et al. Ultrasound-Assisted Tumor Surgery in Breast Cancer – A Prospective, Randomized, Single-Center Study (MAC 001). Ultraschall in Med 2019; 40: 326-332 DOI: 10.1055/a-0637-1725.
- 31 Krekel NM, Haloua MH, Lopes CardozoAM. et al. Intraoperative ultrasound guidance for palpable breast cancer excision (COBALT trial): a multicentre, randomised controlled trial. Lancet Oncol 2013; 14: 48-54 DOI: 10.1016/S1470-2045(12)70527-2.
- 32 Olsha O, Shemesh D, Carmon M. et al. Resection margins in ultrasound-guided breast-conserving surgery. Ann Surg Oncol 2011; 18: 447-452 DOI: 10.1245/s10434-010-1280-0.
- 33 Hahn M, Kuner RP, Scheler P. et al. Sonographic criteria for the confirmation of implant rotation and the development of an implant-capsule-interaction (“interface”) in anatomically formed textured breast implants with texturised Biocell-surface. Ultraschall in Med 2008; 29: 399-404 DOI: 10.1055/s-2007-963020.
- 34 Schulz-Wendtland R, Bock K, Aichinger U. et al. Mamma-Sonographie mit 7,5 MHz versus 13 MHz: Ist eine Verbesserung der diagnostischen Sicherheit im Rahmen der komplementären Mammadiagnostik möglich?. Ultraschall in Med 2005; 26: 209-215 DOI: 10.1055/s-2005-857897.
- 35 Eisenbrey JR, Dave JK, Forsberg F. Recent technological advancements in breast ultrasound. Ultrasonics 2016; 70: 183-190 DOI: 10.1016/j.ultras.2016.04.021. . Epub 2016 Apr 25
- 36 Hahn M, Roessner L, Krainick-Strobel U. et al. [Sonographic criteria for the differentiation of benign and malignant breast lesions using real-time spatial compound imaging in combination with XRES adaptive image processing]. Ultraschall in Med 2012; 33: 270-274 DOI: 10.1055/s-0029-1245497.