Bibliogr. s. 14

Background: The aim of the study was to determine the diagnostic problems encountered in breast diseases, their causes as well as the methods of the procedure in such cases. Material/Methods: Clinical and mammographic examinations were conducted in 5445 women aged 35-70 years. The patients were divided into 3 groups: group I comprised 4200 patients after screening (aged 50-69 years), group II - 915 (aged 40-49) and group III - 330 high-risk patients. Additional sonomamography was performed in 336 women (8%) in group I, 192 (21%) in group II and on all the patients in group III. Anamnesis, palpation, mammography (MMG) in 2 projections and magnified X-rays were performed. In cases of an unclear image the following procedures were undertaken: sonomammography (USG), fine needle aspiration (FNA), mammotomy and surgical biopsy The MMG and USG images were evaluated in BI-RADS scale. The false positive and false negative results were established. Results: In group I, 228 FNA biopsies (5.4%) were carried out, 55 cancers (1.3%), 32 false positive, 5 false negative radiological results were diagnosed. In II group 21 women underwent FNA, false positive radiological diagnoses occurred in 14 cases. In group III comprising 60 women who had undergone FNA, 18 cancers were observed. These proved false positive diagnosis in 8 cases and false negative in 4 cases. It was found, that the most common reasons for error were due to dense cysts displaying with irregular outlines and microcalcifications accompanying hormonal dysfunction. The displacement of tumors near the pectoral muscle or the nipple also interfered with establishing the correct diagnosis. Conclusions: The diagnostic problems can be due to the inherent limitations of the methods, the physical nature of the breast and localization of the changes. The diagnosis of the benign process should be established on the basis of radiological, cytological and histopathological methods. The radiologically unclear changes should be diagnosed with the use of FNA/ core biopsy, mammotomy or surgical biopsy. In cases of hormonal dysfunctions and during the conservative treatment, follow-up after 6 months is suggested.