[The diagnostic contribution of direct radiographic enlargement and of echography in the study of breast neoplasms].

To compare the diagnostic value and the role of plain radiographic magnification and of ultrasonography (US) in breast cancer evaluation, 83 malignant tumors were studied with mammography, plain radiographic magnification and US. Microcalcifications were not included in our study. All tumors subsequently underwent histology or cytology. In our series, the malignant nature of the lesion was unquestionably proved in 53% of cases while a possible malignancy was suspected in 36% and a benign nature was incorrectly suspected in 11% of cases with mammography. The diagnostic value of plain radiographic magnification was compared with that of US; breast patterns, mammographic and clinical findings were considered. As for breast patterns, plain radiographic magnification was more accurate in evaluating fatty breast than both mammography and US, allowing the correct diagnosis of 58% of questionable mammographic findings, vs. 33% of US. On the contrary, US was more accurate in dense breasts, allowing the correct diagnosis of 77.7% of mammographic misdiagnoses vs. 33.3% only of plain radiographic magnification. As far as mammography is concerned, US was more accurate than plain radiographic magnification in the assessment of round masses (71.4% vs. 38.1%, respectively), whereas plain radiographic magnification was more accurate than US in stellate masses (100% vs. 92.7%, respectively). As far as clinical findings are concerned, plain radiographic magnification sensitivity was substantially the same in the assessment of symptomatic and asymptomatic lesions (91.5% vs. 89%, respectively), whereas US sensitivity was higher in symptomatic (97%) than in asymptomatic (69%) lesions. The rate of false-negative US diagnoses (14.4%) was higher than those of mammography and of plain radiographic magnification. Negative US findings must be considered with caution and are not sufficient to settle a radiologic doubt.