High-frequency and three-dimensional ultrasonography for conventional and invasive diagnostic procedures of the breast

Objective: Ultrasonography has become an integral component of the evaluati on of palpable and nonpalpable lesions of the female breast. We assessed th e usefulness of high-frequency ultrasonography and three-dimensional Ultras onography for evaluating the benign or malignant status of sonographically reproducible lesions of the breast in patients undergoing biopsy procedures . Methods: We reviewed 300 patients who underwent clinical, sonographic and i nvasive evaluation of a sonographically reproducible breast lesion over a 1 5-month period. A total of 164 cases were evaluated with three-dimensional ultrasonography (Kretz Voluson 530 D MT 10-13.5MHz), The two-dimensional an d three-dimensional ultrasound findings were compared with the results of n eedle biopsy (16-gauge needle with a free-hand technique) or open biopsy. Results: High-frequency ultrasonography (ATL 3000, 12.5 MHz) had an overall sensitivity of 96% and a specificity of 70%. For nonpalpable lesions, thre e-dimensional ultrasonography increased the specificity from 65% to 72%. Ne edle biopsy had a sensitivity of 96% and a specificity of 99% with a mean o f 1.66 biopsies per lesion. Conclusions: Three-dimensional ultrasonography of the breast provides addit ional morphologic criteria for differentiating benign from malignant breast lesions, particularly in small and nonpalpable breast lesions. Needle biop sy under ultrasound guidance is a reliable technique to evaluate the histol ogy of focal breast lesions. Three-dimensional ultrasonography permits more precise placement and localization of the biopsy needle.