Title: Differentiation of Benign and Malignant Breast Lesions Based on Ultrasound Criteria
Authors: Usha Kumari K, Sophy Susan Manuel
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.19
Abstract
Aim: To evaluate the usefulness and accuracy of ultrasound imaging for distinguishing between benign and malignant breast masses, with FNAC or biopsy results as reference standard in a study population based in South India.
Materials and Methods: The records of breast ultrasound examination findings of 50 patients with solid breast masses were retrospectively reviewed. Criteria such as size, shape of the lesion, circumscribed or irregularity of margins such as indistinct, angular, microlobulate or spiculated, posterior enhancement or shadowing, calcifications, echo pattern, associated features mainly duct changes and W/AP ratio were evaluated and a diagnosis reached based on ultrasound criteria. Gold standard was kept as FNAC or biopsy.
Results: The sensitivity of breast US for malignancy was 96%, specificity 85%, positive predictive value 94%, negative predictive value 92% and accuracy 93%, Among the benign criteria marked hyperechogenicity and ellipsoid shape had 100% negative predictive value. Negative predictive value of 3 or fewer gentle lobulations and thin echogenic capsule was 87.5% each. 75% of fibroadenomas showed W/AP ratio >1.4 and 93% of malignant lesions showed W/AP ratio <1.4 (p value <.001 statistically significant).
Conclusion: The data confirm that using strict sonographic criteria it is possible differentiate benign from malignant lesions with confidence. Furthermore, applying these criteria can obviate need for biopsy in a group of benign solid breast lesions.
Keywords: Breast carcinoma, breast neoplasms, sonography, positive predictive value, negative predictive value.
