Comparison of written reports of mammography, sonography and magnetic resonance mammography for preoperative evaluation of breast lesions, with special emphasis on magnetic resonance mammography

Mammography and sonography are the standard imaging techniques for detection and evaluation of breast disease [1]. Mammography is the most established screening modality [2]. Especially in young women and women with dense breasts, sonography appears superior to mammography, and differentiation between solid tumours and cysts is easier. Sensitivity and specificity of sonography or mammography are higher if sonography and mammography are combined [3].It is generally accepted that MR mammography is the most sensitive technique for diagnosis of breast cancer, whereas the reported specificity of MR mammography varies [4,5,6,7,8,9,10,11,12]. In those studies, MR mammography was performed and evaluated by highly specialized radiologists in a research setting. It was therefore the purpose of the present prospective study to compare the validity of MR mammography with mammography and sonography in clinical routine practice. Findings for the three diagnostic methods documented on routine reports that were available to the surgeon preoperatively formed the basis of this comparison. Special emphasis was placed on the identification of multifocal and multicentric invasive disease.Between September 1995 and September 1998, 413 patients with abnormal breast findings were referred for histological evaluation to the Department of Gynecology of the Friedrich-Schiller University, Jena, Germany. Patients had been selected and referred because of the presence of breast lesions detected by palpation and/or mammography and/or sonography. In addition, MR mammography was performed in all patients. We excluded five patients with invasive cancer who had a history of core-needle or fine-needle biopsy cancer within 2 weeks before referral, because the presence of haematoma may mimic false-positive findings on MR mammography. In addition, five patients who did not keep still during MR mammography were excluded.Analysis of the sonograms taken in patients with histologically confirmed carcinoma in