What ultrasonography can tell in breast masses that mammography and physical examination cannot.

The capability of ultrasonography to provide additional information to the physical and mammographic examination for therapeutic decision was investigated in a prospective study. Four hundred patients with palpable or radiologic breast masses requiring surgical biopsy were studied. The high resolution and accuracy of ultrasonography vs. mammography in the diagnosis of cystic masses (96%, 63/66 vs. 42%, 20/48) (p less than 0.001) and fibrocystic masses (84%, 131/156 vs. 74%, 80/108) (p less than 0.10), led to a substantial reduction of surgical biopsies in favor of aspiration or follow-up policy, particularly when physical examination and mammography were inconclusive. Breast cancers were accurately diagnosed in 73% (88/120) by sonography and 84% (98/116) by mammography (p greater than 0.10). The major limitation of ultrasonography was noticed in the diagnosis of minimal breast cancer (23%, 5/21) due to its inability to visualize microcalcifications. Our study validates the importance of ultrasonography in the diagnosis and therapeutic decision of cystic and fibrocystic masses but cannot substitute mammography in early detection of breast carcinoma.