Comparison Study Of Ultrasonography And Mammography For The Diagnosis Breast Lesion With Microcalcification

ObjectiveTo explore the diagnostic value of mammography and high frequency ultrasonography (US) in the diagnosis of breast lesion with microcalcifications.MethodsOne hundred and seventeen breast lesions with microcalcifications in Shandong provincial hospital were confirmed by operation and history of biopsy, and the pathologic diagnosis was obtained. All of these breast lesions without any history of biopsy, physical therapy, radiotherapy or operation before the complete digital mammography and high frequency ultrasonography (US) were both performed.All the US was performed using HDI5000 US system which used linear array high frequency probe, and the frequency of probe was 7-12MHz.The patients adopt supine position when ultrasound comprehensive examined bilateral breast, and multi-section,multi-angle scanning to discover breast mass, To lower gain conditions appropriately and multi-angles machinate the probe to show microcalcification. Recorded lesion's size, edge, shape, internal echo, mass drive aspect ratio, pone attenuation and blood flow condition. Comprehensive analysis and judgment of the benign and malignant of breast lesion.All mammography examinations were under taken by full-field digital mammography, which machine was GE digital plate molybdenum target mammary machine which used high definitional tachy-collcetion work station and high resolution display's browsing station. The patients adopt standing position. Mammography examination used CC position and MLO position, added lateral position and zoom photograph if it is necessary. Observed and record the size, shape and distribution of the microcalcifications in breast lesion and the size, shape, margin of the lesion. Comprehend analysis and judgment of the benign and malignant of breast lesion.Statistical analysis:The sensitivity, specificity, accuracy, false negativity rate , false positively rate , positive predictive value and negative predictive value for US diagnosis were calculated.The sensitivity, specificity, accuracy , false negativity rate , false positively rate , positive predictive value and negative predictive value for mammography diagnosis were calculated.The sensitivity, specificity, accuracy, false negativity rate , false positively rate , positive predictive value and negative predictive value for combination US and mammography diagnosis were calculated.Statistical data-processing applies package SPSS13.0. x~2-test is applied for enumeration data statistical analysis, to P <0.05 for the differences were statistically significant.ResultsThe high frequency ultrasound for the detection rate of breast microcalcifications was 66.7%, which was high about 87.5%in malignant breast lesions and only 33.3%in breast benign lesion.The sensitivity, specificity, accuracy, false negativity rate , false positively rate , positive predictive value and negative predictive value of US were 68.7%,86.7%,75.6%,10. 7%,43. 1%,69. 4%,86. 7%.The sensitivity,specificity,accuracy,false negativity rate,false positively rate,positive predictive value and negative predictive value of mammography were 75.0%,80. 0%,74. 3%,21.4%,35.3%,75.0%,73.3%.The sensitivity, specificity,accuracy,false negativity rate,false positively rate,positive predictive value and negative predictive value of combination US and mammography were 89.6%,90.0%,92.3%,5.8%,14.6%,90.2%,91.1%. Mammography for breast with microcalcification disease diagnosis has a high sensitivity; high-frequency ultrasound has a high specificity. And combined the two can improve the diagnosis of breast microcalcifications the accuracy (x~2 for 7.07, 8.07, P <0.05).Conclusions1. High-frequency ultrasound was used for detection of breast microcalcifications have certain advantages, particularly in malignant breast lesions. High-frequency ultrasound can show characteristics of breast lesions, such as disease patterns, borders, and the echo of the situation, the rear echo attenuation and blood flow situation.2. The diagnose accuracy of the High frequency ultrasound and Mammography was similar. The high-frequency ultrasound diagnosis of breast lesion with high specificity, and mammography has higher sensitivity, which were breast disease check the ideal method.3. Combining high-frequency ultrasound with mammography diagnosis of breast lesions with microcalcification higher than using either modality alone, US and mammography have completely advantage when thy were used to detect breast lesion with microcalcification.