[Mammography and mammary ultrasonography: which examination sequence is preferable?].

PURPOSE To compare primary mammography diagnosis (ultrasound report available) with primary ultrasound diagnosis (mammography report available). METHODS 89 preoperative patients with suspicious lesions were included. Mammography and ultrasound of all patients were evaluated by two independent experienced readers under clinical conditions. The reports of the complementary modality were available to both observers. Lesion evaluation was done on a per breast basis, in cases of multiple lesions in respect of the lesion with the greatest risk of malignancy. RESULTS 39 benign and 59 malignant lesions were found. Primary mammography and primary ultrasound yielded 3 and 8 false positives and 10 and 13 false negatives. Concerning the palpable lesions (n = 59), primary mammography and primary ultrasound had no and 4 false positives and 7 and 8 false negatives, respectively, for the non palpable lesions, the figures were 3 and 4 false positive and 3 and 5 false negatives. CONCLUSIONS Mammography remains the method of first choice in early detection of breast cancer, whereas breast ultrasound should be performed after and in knowledge of the mammogram, in consideration of the known indications (equivocal palpable lesion and mammographic opacity, dense breast).