DIAGNOSTIC ACCURACY OF MAMMOGRAPHY AND ULTRASONOGRAPHY FOR BREAST DISEASES

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DIAGNOSTIC ACCURACY OF MAMMOGRAPHY AND ULTRASONOGRAPHY FOR BREAST DISEASES

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 5

Abstract

BACKGROUND Detecting the breast pathologies, at its earliest possible stage is the ultimate goal in imaging the breast. Diagnosis chiefly includes radiological investigations like mammography and ultrasonography followed by biopsy. The incidence of breast cancer deaths can be reduced by 30% by the routine screening of healthy women with mammography. USG plays a key role in differentiating solid and cystic masses. It is useful in the evaluation of palpable masses not visible radiographically. The purpose of this study was to compare the role of mammography and ultrasonography in the evaluation of breast diseases and to compare the diagnostic accuracy of ultrasonography and mammography for diagnosing breast diseases when doing individually and its combination on same patients. MATERIALS AND METHODS Data for this descriptive study were sourced from all female patients above 15 years of age who presented with symptoms of breast diseases like breast lump, pain in the breast and nipple discharge to outpatient and inpatient surgery department in SRM Medical College Hospital and Research Centre, Kattankulathur during the period from June 2013 to May 2016. Data collection methods include direct interview, clinical examination, mammography and ultrasonogram of symptomatic breast followed by FNAC (Fine Needle Aspiration Cytology) in all patients and excision biopsy in selected cases. Then the reports of FNAC/histopathological examinations were compared with the results of mammography and ultrasonogram of breast. RESULTS According to this study, MG showed a sensitivity of 82.6% compared to 73.9% for USG in detecting fibroadenoma. However, their combined approach resulted in 95.7%. In case of fibrocystic disease MG showed 27.6% and USG only 75.9% and the combination resulted in 75.9%. For diagnosing carcinomas MG had a sensitivity of 83.3% and USG 73.3%, but the combination had an efficiency of 100%. Overall, the histopathological results when correlated with each modality finding showed that MG had an efficiency of only 61.3% and USG only 77.4% when used alone in detecting these lesions of the breast compared to an efficiency of 91.2% obtained by their combined approach. Positive predictive value of ultrasonogram and mammogram was 98.6% and 100% respectively. Negative predictive value for USG and MG was 22.2% and 15.2% respectively with the accuracy rate of 78% for USG and 61% for MG. CONCLUSION Mammogram and ultrasonogram are two important non-invasive investigations available for evaluating breast diseases. Mammogram is more efficient in diagnosing malignant diseases of the breast, while ultrasonogram is more efficient in diagnosing benign breast diseases. The combinations of ultrasonogram and mammogram will diagnose almost all diseases of the breast. By using these non-invasive diagnostic modality, unnecessary invasive procedures like FNAC biopsy can be avoided.

Authors and Affiliations

Rajesh Chakkarapani, Balaji Durairaj

Keywords

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EP ID EP365287
DOI 10.14260/jemds/2018/135
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