ABSTRACT
Background: According to numerous studies the positive predictive value for biopsy can be improved by proper complete diagnostic work up in which sonography is also included. Developments in imaging technique with high resolution ultrasonography has helped us to distinguish between benign and malignant masses. This study has been carried out for the ultrasonological characterization of palpable breast masses and to categorize them as benign and malignant and to correlate these benign and malignant breast masses with tissue diagnosis. Methods: Our study was a prospective analysis. The study included 150 patients with age range between 22–75 years (mean age, 40 years) and with a history of palpable breast masses. Data for our study was collected from the patients referred to Department of Radio diagnosis at Academy of medical sciences, Pariyaram, Kannur for the period of two years. A structured, pre-prepared case proforma (CP) was used to enter the clinical history, physical examination findings, investigations-sonography and histopathology findings. Initially sonography was performed with GE Voluson 730 expert scanner with 7.5-10 MHz linear array transducer and data was obtained of only solid masses. Then tissue diagnosis was obtained in all 150 cases. Later the tissue diagnosis results were correlated with sonological findings by statistical analysis. Results: The US features most predictive of a benign tissue diagnosis were oval or round shape, circumscribed margins, and width-to–AP dimension ratio greater than 1.4. The features most predictive of a malignant tissue diagnosis were spiculated or microlobulated margins, irregular shape, ill-defined margins, and width-to–AP dimension ratio of 1.4 or less. Some features like the effects of masses on posterior echo intensity were not reliable in differentiating between benign and malignant lesions. Some features like echogenicity showed excellent correlation with a benign or malignant tissue diagnosis were too infrequent to be generally applicable. Conclusions: In our study we performed the prospective analysis of the sonomammography findings in correlation with tissue diagnosis. The US features in our study most predictive of a benign tissue diagnosis were oval or round shape, circumscribed margins, presence of edge refraction, and width-to–AP dimension ratio greater than 1.4. The features most predictive of a malignant tissue diagnosis were spiculated or microlobulated margins, irregular shape, ill-defined margins, and width-to–AP dimension ratio of 1.4 or less. The results of our study were encouraging in that we were able to identify the most applicable US features for differentiating benign from malignant solid masses. These features have the potential to help decrease the number of biopsies performed for benign solid masses