J Korean Surg Soc.
2000 Oct;59(4):463-469.
Validity of Office-Based Ultrasonography in the Diagnosis of a Palpable Breast Mass: A prospective study
- Affiliations
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- 1Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
- 2Department of Diagnostic Radiology, College of Medicine, Chungbuk National University, Cheongju, Korea.
- 3Department of Preventive Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.
Abstract
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PURPOSE: Current evidence indicates that ultrasonography of the breast is an important adjunct to
mammography and clinical examination in the diagnosis of palpable breast abnormalities. An assessment
of the value of office-based ultrasonography of a palpable breast mass performed by a breast surgeon
was the aim of this work. METHODS: A 7.5 MHz linear probe was used to perform office-based
ultrasonography in 109 consecutive female patients having a palpable solid breast mass between August
1998 and December 1999. Breast masses diagnosed histologically as fibroadenomas or breast cancer were
included in this study. The clinical impression from the physical examination (PE), the result of
officed-based ultrasonography done by a surgeon (OUSG), and comprehensive judgement engaging both
PE and OUSG (PEUSG) were recorded in each patient's hospital record as benign or malignant at the
first visit. The diagnostic values of PE, OUSG, PEUSG, mammography (MMG), and ultrasonography
done by a radiologist (USG) were compared. RESULTS: Of 109 masses, a fibroadenoma was diagnosed
in 73 patients while a carcinoma was established in 36 patients. The sensitivity, the specificity, the
accuracy rate, and the kappa coefficient were 91.7%, 89.0%, 89.9%, and 0.780 for PE; 100%, 90.4%,
93.6%, and 0.862 for OUSG; 97.2%, 97.3%, 97.2%, and 0.938 for PEUSG; 90.4%, 89.4%, 90%, and
0.630 for MMG; and 88.9%, 90.9%, 90% and 0.798 for USG. The diagnostic accuracy of PEUSG was
significantly higher than those of PE and MG (p<0.05). CONCLUSION: These data suggest that office-based
ultrasonography of the breast performed by a surgeon is a useful adjunct to clinical evaluation of the
breast mass and permits timely and cost-effective patient care.