Does Real-time Compound Imaging Improve Evaluation of Breast Cancer Compared to Conventional Sonography? / 한국유방암학회지

PURPOSE: Real-time compound imaging obtains multiple coplanar tomographic ultrasound images and combines them into a single compound image, reducing acoustic artifacts and noise. The purpose of this study is to determine if real-time compound imaging improves evaluation of breast cancer compared to conventional sonography. METHODS: From May 2000 to July 2001, we scanned the same axial plane with conventional sonography and real-time compound imaging in 520 patients with solid breast nodules. Twenty-eight cancers in 25 patients which were confirmed pathologically were included in this study. Twenty-five of 28 cases were invasive ductal carcinoma and the remaining three were ductal carcinoma in situ. Each image pair consisted of a conventional ultrasound and a real-time compound image with a stationary probe, to maintain an identical projection. The evaluating points were 1) contrast between cancer and normal breast tissue, 2) depiction of margin, 3) clarity of internal echotexture, 4) clarity of posterior echo pattern, and 5) clarity of internal microcalcifi-cation. Two radiologists graded for quality of images on a 5-point scale and in a blinded fashion and Wilcoxon rank test was used for comparison between conventional and real-time compound images. RESULTS: For reviewer 1/reviewer 2, compound image showed grade improvements in 1) contrast (1.4?0.5/1.4?0.7), 2) margin (1.4?0.5/1.8?0.4), 3) internal echotexture (1.0?0.5/1.4?0.7), 4) posterior echo pattern (?0.9?0.7/?0.8?0.7), and 5) internal microcalcification (1.8?0.5/1.8?0.5). In all evaluating points, there was statistically significant difference between conventional and compound images (P<0.05). CONCLUSION: Real-time compound imaging improves contrast, depiction of margin, and clarity of internal echotexture and internal microcalcification of the breast cancer. But compound image is not effective to evaluate posterior echo pattern of the breast cancer.

A Comparative Study of Breast Cancer of Korean Women according to Age in Radiological, Pathological, and Clinical Findings / 한국유방암학회지

PURPOSE: The incidence of breast cancer is continuously increasing in Korea, and the age of the initially detected breast cancer is younger than western people. The purpose of this study was to compare radiological, pathological, and clinical findings of breast cancers according to age and then contribute to the basis of screening program of breast cancer. METHODS: Retrospectively, the 325 patients who had pathologically confirmed breast cancer were included in this study. The patients were classified into 6 groups according to age, 20~29, 30~39, 40~49, 50~59, 60~69, and more than 70 years. We evaluated the radiological findings of 325 cases of mammography and 144 cases of breast ultrasonography, classified as four types; mass, microcalcification, others, and non-detected lesion, and then analyzed radiological findings according to age. We evaluated pathological and clinical findings according to age and compared with radiological findings. We used Mantel-Haenszel's chi 2 test and trend test for comparison according to age. RESULTS: The incidence of breast cancer was 61 cases (19%) in 30~39 years, 122 (38%) in 40~49 years, 92 (28%) in 50~59 years. Most of breast cancer was invasive ductal carcinoma, 258 (79%) and in situ carcinoma was 32 (10%). Most of in situ carcinoma was detected in 20~59 years, 31/32 (97%). Mammography showed mass in 237 (73%), microcalcification in 45 (14%), other finding in 13 (4%), and non-detected lesion in 30 (9%). Twenty-one (47%) of 45 cases with microcalcification were in situ carcinoma and most of in situ carcinoma was presented as microcalcification on mammography, 21/32 (66%). In twenty-eight of 30 cases (93%) with non-detected lesion on mammography, breast cancer was detected on ultrasonography. In terms of clinical findings, there was no symptom in 12/32 (38%) with in situ carcinoma and 57/258 (22%) with invasive ductal carcinoma. CONCLUSION: The incidence of breast cancer is abruptly increasing from 4th decades and there is no significant difference in radiological and clinical findings according to age. But, most of in situ carcinoma was detected in 20~59 years and presented as microcalcification on mammography. Thus, Screening mammography should be considered from 4th decades.