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Category: Volume 05 Issue 12 December 2017
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Title: Mammography Screening in Benign Breast Disease for Risk Stratification of Malignancy

Authors: Kanishka Sunil Patil, Siddarth Ragupathi, Subith P Bhaskar, Govinda Ambujam

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.100

Abstract

Breast cancer is the most common female cancer worldwide. Although the widespread use of mammography screening has increased diagnosis of benign breast disease, no specific recommendations have been made for surveillance, except for women with atypias, who are usually recommended to undergo surgical excision. With the current advances in reporting by the use of BI-RADS, the standardization is achieved, but its accuracy in terms of histological correlation remains unanswered. This study will try to establish the same and also aid in improving the management of patients. Correlation between mammographic screening and histopathology among patients clinically diagnosed as benign breast disease were assessed for determining the accuracy of BI-RAD system mammography. On approval of Institutional Ethical Committee, 100 women between the age group 30-70 years were enrolled after obtaining written informed consent. Mammogram had100% sensitivity (95%CI=95.77, 100), 87% positive predictive value (95% CI=79.02, 92.24) and 87% diagnostic accuracy (95% CI=79.02, 92.24) as a screening tool in this study, which was statistically significant. Thirty-one to forty years age group constituted maximum percentage (65%), followed by 41-50 years (21%), >50 years age group (9%), 30 years (5%). Mean ± SD being 39.27 ± 7.22years. Majority of the women were multigravida (56%) and have breastfed baby (94%), which is statistically significant (p=0.001 and p= 0.005 respectively) using Pearson Chi-square test. Upper outer quadrant (35%) was the most common site of breast lump followed by lower inner (22.6%), upper inner (20.2%), central (11.7%) and lower outer (10.5%), which was statistically significant using Chi-square test (p=0.044). Three percentage mother and 1% sister had positive history of breast malignancy, which positively correlated with high-risk benign breast disease.

Keywords: Breast, Mammography, BIRADS, benign, lump, malignancy.

References

  1. World Health Organization. World cancer report, GLOBOCAN 2012, International Agency for Research on Cancer (IARC), France: World Health Organization.
  2. Frederick BW Jr, Samuel WB, Bland KI. History of breast cancer. In: The Breast – Comprehensive management of benign and malignant disease, (3rd). Philadelphia: WB Saunders; 2001; 220.
  3. Ballard-Barbash R, Taplin SH, Yankaskas BC. Breast Cancer Surveillance Consortium: a national mammography screening and outcomes database. Am J Roentgenol. 1997;169(4):1001–1008.
  4. Sickles EA, Miglioretti DL, Ballard-Barbash R. Performance benchmarks for diagnostic mammography. Radiology. 2005;235(3):775–790.
  5. Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med. 1985;312(3):146–151.
  6. Van Ravesteyn NT, Miglioretti DL, Stout NK. Tipping the balance of benefits and harms to favour screening mammography starting at age 40 years: a comparative modeling study of risk. Ann Intern Med. 2012;156(9):609–617.
  7. Van Ravesteyn NT, Miglioretti DL, Stout NK. Tipping the balance of benefits and harms to favour screening mammography starting at age 40 years: a comparative modeling study of risk. Ann Intern Med. 2012;156(9):609–617.
  8. Das N,Debbarma G, Debbarma A.A clinico-pathological study of benign breast diseases in rural population. Int J Res Med Sci. 2014;2(3):1067-1069.
  9. Prajapati CL, Jegoda RK, Patel UA, Patel J. Breast lumps in a teaching hospital: a 5 year study. National Journal Of Medical Research. 2014; 4(1):65-67.
  10. Webb PM, Byrne C, Schnitt SJ, Connolly JL, Jacobs T, Peiro G, Willett W, Colditz GA.Family history of breast cancer, age and benign breast disease.Int J Cancer. 2002;100(3):375-8.
  11. Ashbeck EL, Rosenberg RD, Stauber, Charles R. Benign Breast Biopsy Diagnosis and Subsequent Risk of Breast Cancer. Key Cancer Epidemiol Biomarkers Prev. 2007; 16 (3): 467-472.
  12. Kumar KS, Anbalagan P, Udhayasankar V. Clinical study of benign breast diseases. J Evolution Med Dent Sci. 2017;6(2):132-135.
  13. Srivastava P, Arya PK, Khetarpal HS, Shrivastava K, Singh PK. Spectrum of benign breast diseases in a tertiary care hospital of Punjab.2017; 6(79): 5602-5606.
  14. Orel SG, Kay N, Reynolds C, Sullivan DC. BI-RADS categorization as a predictor of malignancy. 1999;211:845– 850.
  15. Liberman L, Abramson AF, Squires FB, Glassman JR, Morris EA,Dershaw DD. The breast imaging reporting and data system: positivepredictive value of mammographic features and final assess-ment categories.AJR. 1998; 171:35-40.
  16. Edwin R, Fisher ER, Palekar A, Kim WS, Redmond C. The Histopathology of Mammographic Patterns. American Society of Clinical Pathologists. 1978; 69(4):421-26.
  17. Park CS, Lee JH, Yim HW, Kang BJ, Kim HS. Observer agreement using the ACR Breast Imaging Reporting and Data system (BI-RADS) – Ultrasound. Korean Journal of Radiology. 2007;8: 397-402.

Corresponding Author

Dr Siddarth Ragupathi

10/25, Banadurai South Street, Kumbakonam – 612001

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