Ultrasound evaluation of breast lesions.

New technology, in combination with mammography, may help doctors determine more accurately which breast lumps require a biopsy to learn if they are cancerous and which most likely are benign. Radiologists who have studied the use of high-resolution, digital ultrasound to evaluate breast lumps, hope that the number of unnecessary breast biopsies can be cut in half.

A study involving more than 1,000 patients at 14 breast centers in the U.S., Canada, and Europe evaluated the use of high-resolution ultrasound to characterize abnormalities found by mammography The patients in the study had abnormal mammograms and were scheduled for breast biopsy. Ultrasound was performed, and the researchers graded the level of suspicion of malignancy on a scale from one to five. They then compared the accuracy of mammography alone to mammography plus ultrasound in predicting which lumps were cancerous.

"In most breast centers, only 20 to 30%. of solid breast masses which are biopsied prove to be cancerous," explains Christopher Merritt, chairman of radiology, Ochsner Clinic, New Orleans, who was coordinator of the trial centers for the study. "We found that, by adding ultrasound to mammography, we achieved a statistically significant improvement in our ability to differentiate benign and malignant masses. By the inclusion of ultrasound in the diagnostic evaluation, the number of unnecessary biopsies can be reduced by up to 50%. While the addition of ultrasound adds to the over-all cost, we believe the actual cost reduction per cancer detected will be 10 to 30%."