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Specificity of Mammography and US in the Evaluation of a Palpable Abnormality: Retrospective Review¹

¹ From the Breast Imaging Center, New York University School of Medicine, 530 First Ave, FPT Suite 8N, New York, NY 10016-6497 (L.M.), and the Department of Breast Imaging, Massachusetts General Hospital, Boston (P.J.S., R.M., S.S. E.D.Y., K.A.M., D.H., M.S., E.A.R., E.H., D.B.K.). Received June 5, 2001; revision requested July 20; revision received January 23, 2002; accepted March 12. From the 1999 RSNA scientific assembly. Address correspondence to L.M. (e-mail: drlindamoy@aol.com).

View larger version (122K): [in a new window]   Figure 1a. Mammograms in a 38-year-old woman with a lump at the 4-o’clock position in the right breast. (a) Craniocaudal and (b) mediolateral oblique mammograms of both breasts. The glandular tissue was considered to be of high density, without a focal abnormality in the area of clinical concern. The pathologic diagnosis was high-grade DCIS.

View larger version (142K): [in a new window]   Figure 1b. Mammograms in a 38-year-old woman with a lump at the 4-o’clock position in the right breast. (a) Craniocaudal and (b) mediolateral oblique mammograms of both breasts. The glandular tissue was considered to be of high density, without a focal abnormality in the area of clinical concern. The pathologic diagnosis was high-grade DCIS.

View larger version (121K): [in a new window]   Figure 2a. Mammograms and a sonogram in a 57-year-old woman with a lump at the 5-o’clock position in the left breast. (a) Craniocaudal and (b) mediolateral oblique mammograms of both breasts. The glandular tissue was considered to be of high density. A subtle mass may have been present on the initial mammogram, best seen on the mediolateral oblique projection. (c) Initial mediolateral oblique mammogram (left) and mediolateral oblique mammogram obtained 4 months later (right). An ill-defined mass (arrow) is seen in the inferior left breast. (d) Transverse sonogram in the lateral lower quadrant demonstrates an ill-defined hypoechoic 4.5-cm mass. The arrows delineate two lobulations within the mass. The crosshairs depict the anteroposterior dimension (2.9 cm) of the mass. The histopathologic diagnosis was stage T3 invasive lobular carcinoma.

View larger version (130K): [in a new window]   Figure 2b. Mammograms and a sonogram in a 57-year-old woman with a lump at the 5-o’clock position in the left breast. (a) Craniocaudal and (b) mediolateral oblique mammograms of both breasts. The glandular tissue was considered to be of high density. A subtle mass may have been present on the initial mammogram, best seen on the mediolateral oblique projection. (c) Initial mediolateral oblique mammogram (left) and mediolateral oblique mammogram obtained 4 months later (right). An ill-defined mass (arrow) is seen in the inferior left breast. (d) Transverse sonogram in the lateral lower quadrant demonstrates an ill-defined hypoechoic 4.5-cm mass. The arrows delineate two lobulations within the mass. The crosshairs depict the anteroposterior dimension (2.9 cm) of the mass. The histopathologic diagnosis was stage T3 invasive lobular carcinoma.

View larger version (144K): [in a new window]   Figure 2c. Mammograms and a sonogram in a 57-year-old woman with a lump at the 5-o’clock position in the left breast. (a) Craniocaudal and (b) mediolateral oblique mammograms of both breasts. The glandular tissue was considered to be of high density. A subtle mass may have been present on the initial mammogram, best seen on the mediolateral oblique projection. (c) Initial mediolateral oblique mammogram (left) and mediolateral oblique mammogram obtained 4 months later (right). An ill-defined mass (arrow) is seen in the inferior left breast. (d) Transverse sonogram in the lateral lower quadrant demonstrates an ill-defined hypoechoic 4.5-cm mass. The arrows delineate two lobulations within the mass. The crosshairs depict the anteroposterior dimension (2.9 cm) of the mass. The histopathologic diagnosis was stage T3 invasive lobular carcinoma.

View larger version (175K): [in a new window]   Figure 2d. Mammograms and a sonogram in a 57-year-old woman with a lump at the 5-o’clock position in the left breast. (a) Craniocaudal and (b) mediolateral oblique mammograms of both breasts. The glandular tissue was considered to be of high density. A subtle mass may have been present on the initial mammogram, best seen on the mediolateral oblique projection. (c) Initial mediolateral oblique mammogram (left) and mediolateral oblique mammogram obtained 4 months later (right). An ill-defined mass (arrow) is seen in the inferior left breast. (d) Transverse sonogram in the lateral lower quadrant demonstrates an ill-defined hypoechoic 4.5-cm mass. The arrows delineate two lobulations within the mass. The crosshairs depict the anteroposterior dimension (2.9 cm) of the mass. The histopathologic diagnosis was stage T3 invasive lobular carcinoma.