Diagnostic Yield of High-Resolution Breast Sonography in Detecting Microcalcifications Compared to Mammography

Background/ Mammography remains the most suitable screening test in detecting microcalcifications as the earliest manifestation of breast malignancy. By means of highfrequency transducers yielding high-resolution breast imaging, some researchers have reported that ultrasonography is capable of depicting microcalcifications in the breast tissue. Therefore, this study has been designed to compare the diagnostic yield of high-resolution breast ultrasonography (HRS) versus conventional mammography.Patients and Seventy-four consecutive patients who had breast microcalcifications (hyperdense foci < 0.5mm) according to standard mammograms, without a prior history of breast disease, surgery, biopsy, chest wall radiation or systemic chemotherapy were enrolled. Considering mammograms as a reference, 46 patients without a mass, voluntarily underwent high-resolution bilateral breast ultrasonography. The mean age was 50.7±10 years (range, 35-85 years). The upper outer quadrant of the breast was the commonest place where microcalcifications were detected (36.9%). A relative frequency of 45.7% was reported for microcalcifications with breast imaging reporting and data system (BIRADS) score 3. An overall 82.6% diagnostic yield was discovered for HRS in detecting microcalcifications; it detected all microcalcifications with BIRADS score 4 and 5, but 57.1% and 90.5% of microcalcifications with BIRADS score 2 and 3, respectively. Cluster microcalcification was the most common pattern (43.5%). Considering the 82.6% diagnostic yield of HRS compared to mammography, it can be proposed as the surrogate modality in locating microcalcifications in procedures such as biopsies and hook-wiring, with the advantage of reducing radiation exposure. HRS may be the future screening modality as a result of feasibility, safety, compliance and accuracy.