Automated water-path full-breast sonography: correlation with histology of 176 solid lesions

A comparative study with mammography and physical examination showed that automated water-path whole-breast sonography contributed to the care of at least one-half of 786 study patients (separate report). Clinical application then followed in an additional 2530 women in whom there were 107 biopsy-proven cancers, 69 discrete biopsied benign lesions, and 121 biopsies of poorly defined lesions, usually some form of fibrocystic disease without a discrete mass. Breast sonography demonstrated 72% of the cancers and detected six cancers not seen on mammography. Although there was considerable overlapping of sonographic characteristics of benign and malignant diseases, most lesions were differentiated. Only 10% of the solid benign lesions had some characteristic of malignancy, and in 90% of the infiltrating duct carcinomas, findings suggested the histologic diagnosis. While breast sonography must be considered a complement to physical examination and mammography, the procedure can reliably differentiate the histologic types of at least 83% of discrete benign lesions and 75% of cancers. In 90% of all solid breast lesions, sonography differentiated benign and malignant processes.