Ultrasound Effective at Diagnosing Localized Breast Lumps and Pain, Finds Study

Frequent focal breast complaints in women include pain, lumps, nipple discharge, and other symptoms and conditions that are confined to a specific area of the breast. The most common complaints are pain and the presence of lumps. For women 30 years or older with localized breast complaints, the standard diagnostic tool is digital breast tomosynthesis (DBT) followed by targeted ultrasound. While DBT provides an overall image of both breasts, ultrasound is more effective for specific area imaging of the breast. The quality of ultrasound images has significantly improved in recent years. Now, a new study has found ultrasound to be an effective standalone diagnostic method in patients with focal breast complaints.

For the study, researchers at Radboud University Medical Center (Nijmegen, the Netherlands) assessed the effectiveness of ultrasound as a standalone diagnostic method in women over the age of 30 who reported localized breast complaints. Among the 1,961 women included in the study, breast lumps or localized breast pain were the most common symptoms reported. The researchers identified seven subgroups of focal complaints. Targeted ultrasound was the initial evaluation for all patients, followed by DBT, if required, and biopsy after ultrasound. Since the ultrasounds were performed first, the participating radiologists interpreted them without being influenced by the DBT images.

The researchers discovered that ultrasound alone provided an accurate diagnosis for 1,759 (90%) out of 1,961 patients in their analysis. More than 80% of the complaints turned out to be normal or benign findings like cysts. Biopsies were performed on 374 patients based on ultrasound results, which led to 192 symptomatic breast cancer diagnoses. These findings suggest that ultrasound may be particularly beneficial in low- or middle-income countries where it is more readily available compared to DBT. The cost-effectiveness of ultrasound and the improved patient comfort during the procedure are also essential factors to consider when expanding its implementation in the diagnosis of symptomatic breast cancer.

“We found that the diagnostic accuracy of ultrasound is high in women with focal breast complaints,” said study co-author Linda Appelman, M.D., a breast radiologist in the Department of Medical Imaging at Radboud University Medical Center. “Our study showed that ultrasound alone can effectively diagnose focal breast complaints in a large majority of women. In a setting with limited resources or an already existing screening program, initial ultrasound might be a better alternative compared to mammography.”

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