Article ID: JJMU.R.246
In this section, we describe the flow of examinations for diagnosis of breast cancer, including close examination leading to surgery, and evaluation of the extent of the breast cancer immediately before surgery. Also discussed is the methodology of ultrasonography tools, especially in contrast-enhanced ultrasound. It is well known that Sonazoid, a second-generation ultrasound contrast agent used in contrast-enhanced ultrasound, is a pure intravascular contrast agent that does not leak out of blood vessels, unlike the water-soluble contrast agents used in CT and breast MRI examinations. Therefore, it can be expected to provide detailed blood flow information and has in recent years been commonly applied in modern clinical practice. In general, after a definitive histological breast cancer is diagnosed, its extent is comprehensively assessed based on the results of mammography, ultrasonography (including elastography and color Doppler imaging), and breast MRI. Second-look US is performed for lesions found during this process, and a qualitative diagnosis is made on an individual basis. Based on these factors, a comprehensive evaluation is made to determine the surgical options. If a partial resection is selected along with the surgical technique, the evaluation of extent is important to determine the extent of resection. We describe the significance of each modality, as well as the role of contrast-enhanced ultrasound and what determines its significance. Finally, we will discuss actual cases and the specific processes leading up to surgery.
