RSS-Feed abonnieren
DOI: 10.1055/s-0029-1245243
© Georg Thieme Verlag KG Stuttgart · New York
Value of Ultrasound in Preoperative Local Staging in Early Breast Cancer
Wertigkeit der Mammasonografie in der Größendetektion von HerdläsionenPublikationsverlauf
received: 21.5.2009
accepted: 2.2.2010
Publikationsdatum:
20. April 2010 (online)

Zusammenfassung
Ziel: Ziel der vorliegenden Arbeit war es, die Übereinstimmung der Metrik von intramammären Herdläsionen zwischen Mammasonografie und histologischem Präparat zu untersuchen und mögliche Einflussfaktoren auf Untersuchungsdiskrepanzen zu charakterisieren. Material und Methoden: Bei 460 Patientinnen, von denen 445 maligne Läsionen aufwiesen, wurden retrospektiv die sonografischen Ergebnisse mit den Maßen des Operationspräparates verglichen. Des Weiteren wurde der Datensatz nach Histologie, Tumorstadium, Alter, Grading und neoadjuvanter Therapie analysiert. Ergebnisse: Der Vergleich zwischen Mammasonografie und Operationspräparat zeigt eine exakte Größenmessung der Läsionen vor allem im Stadium T 1 und T 2 und bei duktal invasiven Karzinomen. Mit höherem Tumorstadium wird die Sonografie in der Messung ungenauer. Alter und Grading beeinflussen die Messgenauigkeit der Sonografie nicht. Lobulär invasive Mammakarzinome weisen ebenfalls eine hohe Ungenauigkeit auf. Schlussfolgerung: Je größer das Tumorstadium, desto ungenauer wird die Mammasonografie. Da die Unterschiede in der Messgenauigkeit sowohl in der univariaten, wie auch in der multivarianten Analyse gleich sind, ist davon auszugehen, dass Tumorstadium und histologischer Typ aufeinander keinen Einfluss im Sinne der Messgenauigkeit haben.
Abstract
Purpose: The purpose of this study was to determine the precision of breast ultrasound for the measurement of breast lesions compared to the histological measurement. A number of other dependent variables were also analyzed. Material and Methods: 460 patients with 445 malignant lesions were examined using breast ultrasound and the lesions were measured and compared to the histologically measured size. The data was further analyzed according to histology, tumor stage, age, grading and therapy. Results: Metric comparison showed good correlation between sonography and the pathologically measured size of breast lesions, especially in tumor stage T 1 and T 2 and within ductal invasive carcinomas. Higher tumor stages lead to imprecise measurements and the histological type of lobular invasive carcinoma also results in imprecise measurements. Age and grading do not influence measurement precision. Conclusion: Breast ultrasound allows precise measurement of breast lesions especially at lower tumor stages. The higher the tumor stage, the more imprecise the measurement becomes. Multivariate analysis shows no cross impact between tumor stage and histological type with respect to the quality of measurement.
Key words
breast - mammography - ultrasound 2D
References
- 1
Parkin D M, Bray F, Ferlay J. et al .
Estimating the world cancer burden: Globocan 2000.
Int J Cancer.
2001;
94
153-156
MissingFormLabel
- 2
Nyström L, Andersson I, Bjurstam N. et al .
Long-term effects of mammography screening: updated overview of the Swedish randomised
trials.
Lancet.
2002;
359
909-919
MissingFormLabel
- 3
Michael M, Garzoli E, Reiner C S.
Mammography, Sonography and MRI for Detection and Characterization of Invasive Lobular
Carcinoma of the Breast.
Breast Dis.
2009;
30
21-30
MissingFormLabel
- 4
Jackson V P.
The role of US in breast imaging.
Radiology.
1990;
177
305-311
MissingFormLabel
- 5
Zonderland H M.
The role of ultrasound in the diagnosis of breast cancer.
Semin Ultrasound CT MR.
2000;
21
317-324
MissingFormLabel
- 6
Nothacker M, Duda V, Hahn M. et al .
Early detection of breast cancer: benefits and risks of supplemental breast ultrasound
in asymptomatic women with mammographically dense breast tissue. A systematic review.
BMC Cancer.
2009;
9
335
MissingFormLabel
- 7
Ohlinger R, Heyer H, Thomas A. et al .
Non-palpable breast lesions in asymptomatic women: diagnostic value of initial ultrasonography
and comparison with mammography.
Anticancer Res.
2006;
26
3943-3955
MissingFormLabel
- 8
McCavert M, O’Donnell M E, Aroori S. et al .
Ultrasound is a useful adjunct to mammography in the assessment of breast tumours
in all patients.
Int J Clin Pract.
2009;
63
1589-1594
MissingFormLabel
- 9
Fine R E, Staren E D.
Updates in breast ultrasound.
Surg Clin North Am.
2004;
84
1001-34, v-vi
MissingFormLabel
- 10
Leconte I, Feger C, Galant C. et al .
Maldague, Mammography and subsequent whole-breast sonography of nonpalpable breast
cancers: the importance of radiologic breast density.
Am J Roentgenol.
2003;
180
1675-1679
MissingFormLabel
- 11
Kelly K M, Dean J, Comulada W S. et al .
Breast cancer detection using automated whole breast ultrasound and mammography in
radiographically dense breasts.
Eur Radiol.
2009;
Sep 2
Epub
MissingFormLabel
- 12
Köhler J, Krause B, Grunwald S. et al .
Ultrasound and mammography guided wire marking of non-palpable breast lesions: analysis
of 741 cases.
Ultraschall in Med.
2007;
28
283-290
MissingFormLabel
- 13
Riebe E, Günther K, Schulz K. et al .
Recurrent disease after breast preserving therapy (BPT) and radiation therapy for
breast cancer--diagnostic yield of palpation, mammography and ultrasonography.
Ultraschall in Med.
2007;
28
394-400
MissingFormLabel
- 14
Madjar H, Ohlinger R, Mundinger A. et al .
[BI-RADS-analogue DEGUM criteria for findings in breast ultrasound--consensus of the
DEGUM Committee on Breast Ultrasound].
Ultraschall in Med.
2006;
27
374-379
MissingFormLabel
- 15
Schulz-Wendtland R, Bock K, Aichinger U. et al .
[Ultrasound examination of the breast with 7.5 MHz and 13 MHz-transducers: scope for
improving diagnostic accuracy in complementary breast diagnostics?.
Ultraschall in Med.
2005;
26
209-215
MissingFormLabel
- 16
Watermann D O, Tempfer C B, Hefler L A. et al .
Ultrasound criteria for ductal invasive breast cancer are modified by age, tumor size,
and axillary lymph node status.
Breast Cancer Res Treat.
2005;
89
127-133
MissingFormLabel
- 17
Snelling J D, Abdullah N, Brown G. et al .
Measurement of tumour size in case selection for breast cancer therapy by clinical
assessment and ultrasound.
Eur J Surg Oncol.
2004;
30
5-9
MissingFormLabel
- 18
Watermann D O, Tempfer C, Hefler L A. et al .
Ultrasound morphology of invasive lobular breast cancer is different compared with
other types of breast cancer.
Ultrasound Med Biol.
2005;
31
167-174
MissingFormLabel
- 19
Heusinger K, Löhberg C, Lux M P. et al .
Assessment of breast cancer tumor size depends on method, histopathology and tumor
size itself*.
Breast Cancer Res Treat.
2005;
94
17-23
MissingFormLabel
- 20
Deyle S, Jörn H, Schmid-Schönbein H. et al .
Quantitative and Qualitative Analysis of the Blood Flow in Breast Tumors using Power
Doppler Ultrasound.
Ultraschall in Med.
2008;
29
233-238
MissingFormLabel
- 21
Merz E, Eichhorn K H, Madjar H. et al .
Indication for and Possibilities of Gynecological Breast Sonography after the Introduction
of Mammography Screening in Germany.
Ultraschall in Med.
2009;
30
3-5
MissingFormLabel
1 * Contributed equally: D. Verga, A. Wöckel
Dr. Dominic Varga
Frauenklinik, Universitätsklinik Ulm
Prittwitzstrasse 43
89075 Ulm
Telefon: ++ 49/7 31/50 05 85 80
Fax: ++ 49/7 31/50 05 85 02
eMail: dominic.varga@me.com