High-frequency breast ultrasound for the detection of microcalcifications and associated masses in BI-RADS 4a patients.

AIM To retrospectively evaluate the diagnostic value of high-frequency ultrasound for the detection of microcalcifications screening in BI-RADS 4a patients. PATIENTS AND METHODS A total of 52 women (mean age 60.5±6.5 years) classified as BI-RADS 4a with microcalcifications, but without associated masses after X-ray mammography (XRM) underwent ultrasound (US) examination (B-mode, ApliPure™ , and MicroPure™ imaging). The results were assessed by two independent investigators and analyzed in relation to the B-classification. Written informed consent was obtained before enrolment. RESULTS The rate of US microcalcification detection was 98.1% (B-mode), 100% (ApliPure™) and 25% (MicroPure™), respectively. The microcalcification extent was significantly underestimated with all US modalities in comparison with XRM, but the difference was lower for ApliPure™ as compared to B-mode. ApliPure™ was also superior in terms of puncture feasibility, facilitating US-guided biopsy in 67.3% as compared to 48.1% (B-mode) and 15.4% (MicroPure™). CONCLUSION In BI-RADS 4a patients, both high-frequency B-mode US and ApliPure™ imaging are highly sensitive for the detection of microcalcifications, whereas MicroPure™ ultrasound imaging is unsuitable. ApliPure™ imaging allowed US guided biopsy for 67.3% of lesions, providing a convenient and economical alternative to stereotactically guided biopsy.