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The Computer-Aided Diagnosis (CAD) software Nagasawa ver. 7.2 was developed by Professor Toru Nagasawa. The purpose of this study was to evaluate our decisions on ultrasonographic (US) findings using the CAD system. We analyzed 29 ultrasonograms (14 breast cancers and 15 fibroadenomas, diagnosed in Osaka City University Hospital). We categorized the US findings of the masses by the features of their shapes and borders (shape: regular, relatively irregular, irregular; border: smooth, relatively rough, rough). Then, we analyzed these ultrasonic categories with the CAD system. Each feature was compared with CAD parameters [shape: deformity index (DI), irregularity (Irr), marginal area index (MAI); border: entropy (Ent), fractal dimension (Fd), surface-length index (SL)]. The CAD parameters of DI, Irr (respectively, = 0.0059), Ent ( = 0.0039), Fd ( = 0.0214), and SL ( = 0.0054) were significantly correlated with US categories. According to multiple comparisons, categories of “regular” and “relatively irregular,” and “smooth” and “relatively rough,” were in the same group. The CAD parameters indicated almost identical results with conventional US findings in breast masses. “Relatively irregular” and “relatively rough” can include “regular” and “smooth,” respectively.

We studied whether the growth of breast cancer as shown by ultrasonography (US) relates to prognosis. A total of 193 patients who had a single mass on US and had undergone radical operation between January 1992 and December 1997 were studied. The tumors on US were classified the direction of backward or forward growth. Internal type was defined as the tumors within the mammary glands; ventral type was tumors that grew upward toward the subcutaneous tissue; dorsal type was masses that grew downward toward the retromammary space; and mixed type was masses that grew in both subcutaneous tissues and retromammary spaces. The ventral type was seen in 106 cases, mixed type in 66 cases, internal type in 12 cases, and backward type in 9 cases. Disease-free survival rate (DFS) and overall survival rate (OS) (10 years) of these types were 100%/100% (internal type), 79%/86% (ventral type), 68%/76% (mixed type), and 39%/67% (dorsal type).We concluded that breast cancer tends to grow ventrally rather than dorsally and that the dorsal type showed poorer prognosis than the other types.