Title: A Study on Characterization of Breast Lesions Using Sonomammography and Comparing with Histopathology

Authors: Deepa S, Beena Sebastian, Radhamani MV, Divya S, Kiran Ravi

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i4.05

Abstract

Introduction: The changing lifestyle practices can lead to a higher number of cancer cases.  Breast cancer is the most common cancer among women in India. It is very important to identify the palpable breast lump as benign or malignant. Ultrasonography is a commonly used screening imaging modality in breast lumps. The present study aims to find out the accuracy of sonomammography by comparing with histopathology.

Materials and Methods: A descriptive study was conducted among female patients for one year.  It included 75 female patients above 20 years of age with palpable breast lesions and bloody discharge from the nipple. Patients with advanced carcinoma, previously treated cases and patients with history of previous breast biopsy were excluded from the study. Designed as diagnostic test evaluation, sensitivity, specificity, positive predictive value and negative predictive value of the variables in differentiation was calculated comparing with histolopathological diagnosis. The features of ultrasonography was analyzed by Cohen’s Kappa for statistical agreement with histopathology.

Results: With sonomammography, the sensitivity, specificity and accuracy obtained were 83.3%, 89.7% and 86.67% respectively for detection of malignancy.

Discussion and Conclusion: Sonomammography is a very useful non-invasive imaging modality having high sensitivity and specificity in diagnosing breast lesions. This study shows that ultrasonography is useful in characterization of breast masses. The requirement of biopsy for breast masses can be reduced. The kappa values for ultrasonographic diagnosis was 0.732 with P value <0.001 which indicates good agreement with histopathology.

Keywords: Benign, breast lesion, histopathology, malignant, sonomammography.

References

  1. Ghoncheh M, Momenimovahed Z, Salehiniya H. Epidemiology, incidence and mortality of breast cancer in Asia. Asian Pac J Cancer Prev. 2016;17:47–52.
  2. Borecky N, Rickard M. Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms. J Med Imaging Radiat Oncol. 2008 Feb;52(1):64-7.
  3. Lehman CD, Rutter CM, Eby PR, White E, Buist DS, Taplin SH. Lesion and patient characteristics associated with malignancy after a probably benign finding on community practice mammography. AJR Am J Roentgenol. 2008 Feb;190(2):511-5.
  4. Rosenberg RD, Yankaskas BC, Abraham LA, Sickles EA, Lehman CD, Geller BM, et al. Performance benchmarks for screening mammography. Radiology. 2006 Oct;241(1):55-66
  5. Sickles EA, Miglioretti DL, Ballard-Barbash R, Geller BM, Leung JW, Rosenberg RD, et al. Performance benchmarks for diagnostic mammography. Radiology. 2005 Jun;235(3):775-90.
  6. Bassett LW, Gold RH, Mirra JM. Nonneoplastic breast calcifications in lipid cysts: development after excision and primary irradiation. AJR Am J Roentgenol. 1982 Feb;138(2):335-8.
  7. Sastre-Garau X, Jouve M, Asselain B, Vincent-Salomon A, Beuzeboc P, Dorval T, et al. Infiltrating lobular carcinoma of the breast. Clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns.Cancer. 1996 Jan 1;77(1):113-20.
  8. Helvie MA, Paramagul C, Oberman HA, Adler DD. Invasive lobular carcinoma. Imaging features and clinical detection. Invest Radiol. 1993 Mar;28(3):202-7.
  9. Moezzi M, Melamed J, Vamvakas E, Inghirami G, Mitnick J, Quish A, et al. Morphological and biological characteristics of mammogram-detected invasive breast cancer. Hum Pathol. 1996 Sep;27(9):944-8.
  10. Kopans DB, Meyer JE, Murphy GF. Benign lymph nodes associated with dermatitis presenting as breast masses. Radiology. 1980 Oct;137(1 Pt 1):15-9.
  11. Paulus DD. Benign diseases of the breast. Radiol Clin North Am. 1983 Mar;21(1):27-50.
  12. Meyer JE, Amin E, Lindfors KK, Lipman JC, Stomper PC, Genest D. Medullary carcinoma of the breast: mammographic and US appearance. Radiology. 1989 Jan;170(1 Pt 1):79-82.
  13. Estabrook A, Asch T, Gump F, Kister SJ, Geller P. Mammographic features of intracystic papillary lesions. Surg Gynecol Obstet. 1990 Feb;170(2):113-6.
  14. Reuter K, D'Orsi CJ, Reale F. Intracystic carcinoma of the breast: the role of ultrasonography. Radiology. 1984 Oct;153(1):233-4.
  15. Paulus DD, Libshitz HI.Metastasis to the breast. Radiol Clin North Am. 1982 Sep;20(3):561-8.
  16. Yang WT, Mok CO, King W, Tang A, Metreweli C. The role of high frequency ultrasonography in the evaluation of palpable breast masses in Chinese women: alternative to mammography? J Ultrasound in Med, Vol. 15, Issue 9 637-644.

Corresponding Author

Beena Sebastian

Associate Professor, Department of Radiodiagnosis

Govt. Medical College, Kottayam, Kerala

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.