EVALUATING SYMPTOMATIC BREAST DISEASE BY COMPLEMENTARY SONOGRAPHY AS AN ADJUNCT TO MAMMOGRAPHY: A MUST

Abstract

Objectives: To evaluate symptomatic breast disease by imaging and calculate sensitivity and specificity of mammography (MG) and ultrasound (USG) independently and using them as a combined modality. Materials and Methods: 352 patients presenting with symptomatic breast disease in the Out-Patient Department or admitted in the wards were included in our study. 193 patients underwent Fine needle aspiration cytology (FNAC) of the abnormality detected either on MG or USG and constituted the study population. Senstivity, specificity and Negative Predictive Value of MG, USG and MG+USG was calculated. Results: Out of 352 patients included in our study, the maximum number of patients (158) were between 31-40 years. Pain and palpable lump were the common complaints in our study group. The most common lesion was fibroadenoma present in 58 patients followed by fibrocystic breast disease in 52, abscess in 18, cysts in 12, and benign duct ectasia in 12 patients. Carcinoma was present in 41 patients and most were in the older age group. The senstivity of MG, USG, MG+USG in diagnosing breast disease was calculated to be 72.7%,90.9%, and 96.96% respectively and specificity of MG, USG, MG+USG was calculated to be 92.35%,89.28%,100% respectively. The negative predictive value (NPV) of MG was lower 74.28% whereas USG had NPV of 89.28%. A higher NPV of 96.55% was seen when MG and USG were used complementary to each other. Conclusion: Using MG and USG as complementary to each other increases the NPV and enhance the confidence of the radiologist in the detection and characterization of the lesion. Age-based criteria should be used to choose the type of diagnostic modality to be used for evaluating the breast.