We described in former papers the anatomy of the ductal tree, its changes during ductal ectasia, periductal fibrosis and the onset of epithelial hyperplasia during pregnancy. The present work was aimed at assessing, between the US patterns of ductal enlargement, a ductal pattern indicating breast cancer. 392 women were examined with mammography and real-time US: breast cancer was demonstrated in 34 of them. The patients were operated on and their carcinomas confirmed at histology. US was performed with radial scans, to depict the ductal system from nipple to gland periphery. Three measurements were made at midsize subsegmental ducts and the mathematical mean was calculated. Ductal thickness ranged 0 to 1.5 mm in 320 healthy women and 2-3 mm in 29 breast cancer patients. 2 mm was considered as the reference value and the following variables were calculated: specificity (90%), sensitivity (85%), positive (43%) and negative (98%) predictive value, and overall accuracy (98%). Then, all these variables were calculated again excluding 54 women with ductal ectasia and the results follow: specificity (89%), sensitivity (84%), positive (42%) and negative (98%) predictive values and overall accuracy (98%). The results appear encouraging, especially relative to the negative predictive value and overall accuracy of this method.
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