A      Evidence based guidelines - the evidence base for ultrasound scanning in generalised lumpiness, breast pain or longstanding nipple retraction

Evidence Table J9 - US

Ultrasound in generalised lumpiness, generalised breast pain or tenderness, or longstanding nipple retraction

A

  

Clinical Problem

Generalised lumpiness, generalized breast pain or tenderness, or longstanding nipple retraction

A1

  

Ref No. in MBUR4 (if any)

J9 US

A2

  

Section in MBUR4

Breast disease

B

  

Search strategy: databases used; period; MeSH headings; other key words.

Medline: breast disease/breast neoplasm/fibrocystic disease of breast 82323; Ultrasonography 16757; English language, 1985-2000; result = 161; 55 reviewed Embase: explode ‘breast disease’ all subheadings 80712; ultras* or sono* LA=English& 1985-2000 27118; result = 568; 142 reviewed

C

  

Search results: no. found;

no. used.

Medline 3; 1 used
Embase 0

D

  

Reference numbers of cited references in attached master list.

J9 3

E

  

Summarised results from each of the cited references

Ultrasound can be used to avert unnecessary biopsy either by excluding a focal mass or by revealing clinically unsuspected malignancy when x-ray mammography shows moderate or marked density in patients complaining of nodularity.

F

  

Statement (= the conclusion drawn from E)

Ultrasound is a useful adjunct to mammography

G

  

Evidence level of F classified I - IV

3

H

  

Investigation

Breast Ultrasound

I

  

Recommendation *

3 Not indicated routinely/Specialised investigation

J

  

Grade of Recommendation

A - C

C

K

  

Comment (if any) to go in booklet version of MBUR5

 In the absence of other signs suggestive of malignancy breast ultrasound is unlikely to influence management.

L

  

Any other comments on this problem (e.g. caveats; suggestions for research or systematic review; cost or opportunity cost; users' views.

Caroline Rubin and Mary Briley

Comments: In the absence of other signs suggestive of malignancy breast ultrasound is unlikely to influence management

References: -

Ref ID Author; Year; Country; Grade (I-IV). Aims Patient population Study design* Results
J9 3 Guyer P B; 1988, UK, III To assess the utility of sonomammography in clinically benign breast disease 480;
121 biopsy proven		 Retrospective Ultrasound can be used to avert unnecessary biopsy by excluding a focal mass or by revealing clinically unsuspected malignancy
* e.g. RCT Comparison (pro/retro-spective)
Series (pro/retro-spective)
Audit