ABSTRACT
Objective: To assess the knowledge, attitude and practices of Pakistani women about breast cancer
Study Design: Descriptive cross-sectional study
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Sep 2012 to Feb 2013
Material and Methods: Two hundred adult female patients and their accompanying attendants were randomly selected [Those with breast complaints were excluded] in outpatient department of military hospitals and were interviewed. In order to gather data patients were asked to reply through a questionnaire along with their demographic profile structure questionnaire, comprising of 28 questions [included both open and closed ended], was used to collect data which was analyzed in the end with the help of SPSS version 15
Results: Mean age of participants was 37.5 +/- 7.5 years. Majority were married [87 percent], housewives [89 percent] with average family income of Rupees 15000 [53 percent]. Majority 94 percent [n=188] had heard about breast cancer. Questions regarding knowledge showed that participants awareness about relationship of breast cancer with obesity, smoking and increasing age was more than 50 percent. Up to 70 percent women had knowledge of breast lump as main symptom of breast cancer. Knowledge regarding diagnostic modalities was very poor. Only 16 percent knew about FNAC/Biopsy and 7.5 percent about mammography. A large majority [90 percent] showed positive attitude and were ready to see a doctor immediately in case they felt a lump in breast but practices of breast self-examination were poor [39 percent]
Conclusion: It was concluded that knowledge of most respondents was limited, practices were poor, but attitude towards breast cancer was positive. Lack of education, socio-cultural taboos and getting information from wrong sources surfaced as leading reasons of unawareness
ABSTRACT
Objective: To observe the diagnostic accuracy of elastography in detecting malignant breast lesion taking strain ratio of 4.8 and histopathology as gold standard
Study Design: Descriptive cross-sectional study
Place and Duration of Study: Department of Diagnostic Radiology, from March to September 2015
Methodology: A total of 137 patients aged 20 to 60 years with clinically palpable breast lump of any size for at least one month duration were included in this study. Patients with purely cystic lesions and those on chemotherapy or hormonal therapy were excluded. Each patient was subjected to sonoelastography followed by ultrasound guided trucut biopsy. The strain ratio cut off value of 4.8 was used to differentiate benign from malignant lesion. Consultant histopathologist's report upon the biopsy specimens was obtained. Results of sonoelastography were compared with histopathology reports
Results: Mean age was 38.20 +/- 10.63 years. The size of the lesion ranged from 2.0 to 6.0 cm, a mean = 3.97 +/- 1.26 cm. The duration since the lump was noticed ranged from 12 weeks [3 months] to 20 weeks [5 months] with a mean of 15.09 +/- 2.56 weeks. Forty-one [29.9%] lesions were labelled malignant on sonoelastography while the actual number of malignant lesions was 35 [25.5%] on histopathology. When the results of sonoelastography were cross-tabulated with histopathology results, the number of TP [true positive], FN [false negative], FP [false positive] and TN [True negative] were 31, 4, 10 and 92 cases, respectively. It yielded 88.57% sensitivity, 90.20% specificity, 75.61% positive predictive value, 95.83% negative predictive value, 89.78% accuracy for sonoelastography in the diagnosis of malignant breast lesion taking histopathology as gold standard with an observed prevalence of malignant breast mass to be 25.55%
Conclusion: Using a strain ratio of 4.8, sonoelastography was found to be 88.57% sensitive, 90.20% specific, and 89.78% accurate in the diagnosis of malignant breast masses