Stellenwert der hochauflösenden Real-Time-Sonographie beim Mammakarzinom

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Abstract
1015 women were examined via scanning echo sonography in the course of a prospective study. Histological results are available from 370 patients following sample excisions or breast amputations. 122 histologically established malignant findings were compared with the preoperatively effected tumour status prognosis obtained via echo mammography and x-ray mammography. In 60 of 122 cases (50%) we found that the patients had carcinomas of stage T1. The sonographic accuracy rate was high (49 out of 60 carcinomas = 81%), whereas x-ray mammography yielded an accuracy of only 77%, since 46 out of 60 cases only had been classified as malignant. The smallest carcinomas visualised by sonography had diameters of 4 mm, 5 mm and 6 mm. In accordance with the fine structure of the tissue, solid carcinomas were recognised most frequently, compared with all other carcinomas, the rate of detection being 96% (26 out of 27). In 64% of all carcinomas, a retrotumourous sonographic shadow was seen. In cases with solid carcinomas, this "sonographic shadow phenomenon", however, was actually present in 34.6% of the cases only, although the rate of identification was highest of all. The results show that echo mammography is the most important additive investigation method in diagnosis of diseases of the breast, besides x-ray mammography, which is of course also an important method. Echo mammography offers a high degree of accuracy in preoperative differential diagnostic assessment of tumour status in malignant processes of the breast.
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