Differentiation of benign and malignant breast microcalcifications: mammography versus mammography-sonography combination.

PURPOSE: The aim of this study was to determine the diagnostic contribution of high-frequency sonography in the diagnosis of isolated clustered microcalcifications detected by mammography. MATERIAL AND METHODS: 238 women (aged 3198) with isolated clustered microcalcifications were examined by mammography and subsequently by high frequency sonography (13 MHz) at the site of microcalcification. 170 underwent surgery. 94 were affected by cancer and 76 by benign pathology. The other 68 were considered to have benign microcalcifications after three years follow-up. The ROC statistical technique was employed to compare the diagnostic role of mammography alone versus the combination of mammography and sonography. The area under the ROC curves was calculated by the Wilcoxon method, without any hypothesis on the distribution of the statistical data. RESULTS: The microcalcifications were neoplastic in 39.5% of cases. The difference between the areas under the mammography ROC curve (area = 0.807, standard error = 0.03) and the mammography-sonography ROC curve (area = 0.819, standard error = 0.028) was not statistically significant (p > 0.05). CONCLUSIONS: The higher sensitivity of mammography-sonography combination demonstrates that it may be useful to perform sonography following mammography when mammography yields a diagnosis of non malignant pathology.