Study substantiates targeted breast ultrasound as primary technique to evaluate focal breast signs, symptoms

Targeted breast ultrasound should be the primary imaging technique used to evaluate focal (confined) breast signs and symptoms in women younger than 30, according to a study in the December issue of the American Journal of Roentgenology (www.ajronline.org).

Breast ultrasound is commonly used to help diagnose breast abnormalities and to characterize potential abnormalities seen on mammography. For women younger than 30 years with focal breast signs or symptoms, targeted ultrasound is the technique typically recommended for initial imaging evaluation. However, questions remain regarding the accuracy of ultrasound and the need for concurrent mammography in this patient population.

Researchers identified and reviewed all ultrasound examinations from January 1, 2002, through August 30, 2006, performed for focal breast signs or symptoms in women younger than 30 years at Seattle Cancer Care Alliance in Seattle, WA. Outcomes were determined by biopsy, 24 months of ultrasound surveillance or linkage with the regional tumor registry.

"The overall incidence of breast malignancy in our study was 0.4 percent," said Wendy B. DeMartini, MD, lead author of the study. "The sensitivity of ultrasound in detecting breast malignancy in our study was 100 percent, because all cancers were sonographically identified. Thus, there were no false-negative exams for which the addition of mammography would have added diagnostic value. Our negative predictive value (NPV) was 100 percent," said DeMartini.

"The high sensitivity and NPV of ultrasound in our investigation substantiates its application as the primary imaging technique in young women with focal breast concerns," she said.