An extended role for ultrasonographers in the evaluation of breast disease: initial experiences

Aims

With the continuing increase in workload of breast assessment units, the role of specially trained ultrasonographers able to perform unsupervised invasive procedures remains unclear.

Method

Between January and December 2001, patients from the Hull and East Riding Breast Care Unit underwent invasive procedures performed under ultrasound control by a specially trained ultrasonographer.

Results

Seven hundred and twenty-eight procedures were performed (age range 12–90, mean age 53 years), which included 175 fine needle aspirations (FNAs) and 389 core biopsies. The histology/cytology results were malignant in 230, suspicious of malignancy in 8, benign but uncertain of malignant potential in 29, benign in 231 and unsatisfactory/normal tissue in 66. Of the FNAs, 20.9% were considered inadequate (acceptable level <25%, National Health Service Breast Screening Programme). Further ultrasound-guided procedures included 20 successful wire localisations, 124 aspirations of cysts and 13 abscess aspirations. In this series one patient suffered a haematoma following a core biopsy.

Conclusion

We conclude that extending the role of ultrasonographers is safe, consistent with current diagnostic requirements and is an appropriate use of resources for the future.