DOI: http://dx.doi.org/10.18203/2349-2902.isj20210374

Accuracy of mammography and sonomammography and its correlation with histopathology in the detection of breast cancer

Soundarya Yamakanamardi, Bharati V. Hiremath

Abstract


Background: Mammography (MMG) plays a pivotal role in the early diagnosis of breast cancer (BC). However, it is sometimes difficult to use it to diagnose palpable breast lesions among young patients. Ultrasound can be used as an adjunct in differentiating cystic and solid masses. Studies evaluating the combination of MMG and sonomammography (SMG) as an adjunct to detect Breast cancer, are quite scarce in the literature. This study aimed to assess the accuracy of MMG and to comprehend the role of ultrasound as an adjunct to MMG for finding breast lesions.

Methods: Women attending the outpatient department (OPD) with complaints of breast lump, or those undergoing MMG screening were included. All patients then subsequently underwent MMG, SMG and biopsy. MMG and SMG findings were then correlated with the histopathology results.

Results: Irregular shape and calcifications (MMG) and hypoechoic pattern (SMG) were found to be significant features differentiating malignant from benign lesions. Calcifications in benign tumors were observed 5.05 times less frequently than in malignant tumors. MMG combined with SMG had a sensitivity of 90.4%, specificity of 82.4%, positive and negative predictive value of 95% and 67% respectively, along with an accuracy of 88.9% in differentiating benign from malignant masses.

Conclusions: SMG used as an adjunct to MMG is a reliable modality, especially in detecting lesions that are not picked up on MMG, including intraductal papilloma and duct ectasia.


Keywords


Diagnostic imaging, Ultrasonography, Pathology, Breast neoplasms

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References


Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol. 2017;13:289-95.

Koo MM, von Wagner C, Abel GA, McPhail S, Rubin GP, Lyratzopoulos G. Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. Cancer Epidemiol. 2017;48:140-6.

Anderson BO, Jakesz R. Breast cancer issues in developing countries: an overview of the Breast Health Global Initiative. World J Surg. 2008;32:2578-85.

Thomassin-Naggara I, Tardivon A, Chopier J. Standardized diagnosis and reporting of breast cancer. Diagn Interv Imaging. 2014;95:759-66.

Gupta K, Sandhu P, Arora S, Bedi G. Role of high resolution ultrasound complementary to digital mammography. Ann Afr Med. 2018;17:117-24.

Mujagić S, Burina M, Mustedanagić-Mujanović J, Šarkanović G. The importance of combining of ultrasound and mammography in breast cancer diagnosis. Acta Med Acad. 2011;40:27-33.

Heinig J, Witteler R, Schmitz R, Kiesel L, Steinhard J. Accuracy of classification of breast ultrasound findings based on criteria used for BI-RADS. Ultrasound Obstet Gynecol. 2008;32:573-8.

Alhamami QS, Almetlag MH, Hussain MA, Al Hashan GM, Alyami AR. Correlation of Ultrasound & Mammography to Histopathology Results in Breast Cancer. A One Year Study at King Khalid Hospital, Najran, Saudi Arabia. Egypt J Hosp Med. 2018;71:2603-9.

Assi HA, Khoury KE, Dbouk H, Khalil LE, Mouhieddine TH, El Saghir NS. Epidemiology and prognosis of breast cancer in young women. J Thorac Dis. 2013;5:2-8.

Lee JM, Arao RF, Sprague BL, Kerlikowske K, Lehman CD, Smith RA, Henderson LM, Rauscher GH, Miglioretti DL. Performance of screening ultrasonography as an adjunct to screening mammography in women across the spectrum of breast cancer risk. JAMA Int Med. 2019;179:658-67.

Health Quality Ontario. Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment. Ont Health Technol Assess Ser. 2016;16(15):1-71.

Health Quality Ontario. Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment. Ont Health Technol Assess Ser. 2016;16(15):1-71.

Scheel JR, Lee JM, Sprague BL, Lee CI, Lehman CD. Screening ultrasound as an adjunct to mammography in women with mammographically dense breasts. Am J Obstet Gynecol. 2015;212:9-17.

Pandia A, Samantaray S, Mohapatara JS, Dash S. A comparative analysis of mammography breast imaging reporting and data system score and fine needle aspiration cytology in the evaluation of palpable breast lump. Int J Res Med Sci. 2019;7:2644-9.

Navya B, Thomas S, Hiremath R, Alva SR. Comparison Of Diagnostic Accuracy Of BIRADS Score With Pathologic Findings In Breast Lumps. Ann Pathol Lab Med. 2017;4:236-42.

Arsalan F, Subhan A, Rasul S, Jalali U, Yousuf M, Mehmood Z. Sensitivity and specificity of BI-RADS scoring system in carcinoma of breast. J Surg Pak. 2010;15:38-43.

Fan L, Strasser-Weippl K, Li J-J, St Louis J, Finkelstein DM, Yu K-D, Chen W-Q, Shao ZM, Goss PE. Breast cancer in China. Lancet Oncol. 2014;15:279-89.

Li H, Zhang S, Wang Q, Zhu R. Clinical value of mammography in diagnosis and identification of breast mass. Pak J Med Sci. 2016;32:1020-5.

Olarinoye-Akorede SA, Aliyu H, Yunusa HG. Pattern of breast ultrasound findings in Zaria, North Western Nigeria. Arch Int Surg. 2018;8:54-8.

Grimm LJ, Miller MM, Thomas SM, Liu Y, Lo JY, Hwang ES, Hyslop T, Ryser MD. Growth Dynamics of Mammographic Calcifications: Differentiating Ductal Carcinoma in Situ from Benign Breast Disease. Radiology. 2019;292:77-83.

Masroor I, Ahmed MN, Pasha S. To evaluate the role of sonography as an adjunct to mammography in women with dense breasts. J Pak Med Assoc. 2009;59:5-7.