By Toshiji Kobayashi M.D. (auth.)
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Extra info for Clinical Ultrasound of the Breast
The dependability of each echographic finding to yield a correct diagnosis was evaluated. In the cases of scirrhous carcinoma, the acoustic middle shadow sign was always observed, which may indicate the high absorption of ultrasonic energy by scirrhous carcinomatous tissue, whereas the benign signs had never appeared in these cases. This is probably the reason for the high diagnostic accuracy rate with scirrhous carcinoma and also may suggest a high acoustic impedance by such tissue. This was later verified by experimental measurement of the absorption coefficient of various breast cancer tissues in different histological types by Calderon et at.
Scirrhous Scirrhous Scirrhous Scirrhous 10. Medullary carcinoma (TI) II. Medullary carcinoma (T2) 12. Medullary carcinoma (T2) a A. Moderate Rich A A A Poor C C C T L T L T L N A A C C T L T L N acoustic middle shadow sign; C. complete disappearance of the distal limit of the tumor mass echo; N. no change in retromammary shadow or intermediate pattern; T. tadpole-tail sign; L. lateral shadow sign. 24 INTRODUCTION Connective Tissue Content and Ultrasonic Attenuation Table lO. Echo Patterns Resulting from Individual Examples of Histological Types According to Connective Tissue Content a Connective tissue Echo pattern Acoustic middle shadow sign Complete disappearance of distal limit of tumor mass echo Tadpole-tail sign Lateral shadow sign No retromammary shadow or intermediate pattern Rich Moderate Poor Nonconnective tissue Rich Moderate S S S PP SSP P Poor S S S PP S PP PP PM MM MM MM MM S PP PP SSP P PM as, scirrhous carcinoma; P, papillary carcinoma; M, medullary carcinoma.
Over 75%; moderate. over 50%; poor. less than 25%. bTweive individual cases were analyzed as to connective and nonconnective tissue content. INTRODUCTION 23 Connective Tissue Content and Ultrasonic Attenuation Table 9. Individual Examples of Histological Types and Resultant Echo Patterns According to Connective Tissue Content Connective tissue a Individual examples of histological types carcinoma carcinoma carcinoma carcinoma (TI) (TI) (T2) (T2) 5. Papillary carcinoma 6. Papillary carcinoma 7. Papillary carcinoma 8.