Objective:

To analyze the causes of missed diagnosis or underdiagnosis of breast cancer combined with the characteristics of preoperative ultrasound and postoperative pathology

improve the understanding of atypical breast cancer imaging and make accurate diagnosis decisions.

Methods:

From January 1st 2014 to December 30th 2018

the data of 43 cases that had been missed by ultrasound or evaluated as low-risk cases was ana

lyzed

of which 25 cases were Breast Image Report and Data System (BI-RADS) grade 3. No target lesion was found in other cases

but suspicious clinical symptoms or abnormal mammography were found. Through preoperative ultrasound combined with signs

X-ray films

specimens and pathological reports

the causes of missed diagnosis and underestimation of breast cancer by ultrasound were summarized.

Results:

The distribution of ultrasound findings and corresponding pathological results of 43 cases were as follows：5 cases had clear boundary of lesions

including solid papillary carcinoma

invasive ductal carcinoma and invasive micropapillary carcinoma; 11 cases had micro lesions

including intraductal carcinoma and papilloma canceration; 3 cases had echo close to surrounding glands

including intraductal carcinoma and invasive ductal carcinoma; 4 lesions had weak mass effect

were invasive lobular carcinoma; 18 lesions distributing along the catheter with unclear boundary were all intraductal carcinoma; 2 lesions diffusing among the whole gland without contrast background wereintraductal carcinoma.

Conclusion:

Breast cancer with specific pathological features is easy to display as low-level image under ultrasound images. Preoperative ultrasound combined with clinical and other imaging data can reduce the rate of missed diagnosis.