STUDY OF KNOWLEDGE OF BREAST CANCER AND ITS EARLY DIAGNOSTICS IN FEMALE TERTIARY HEALTH WORKERS

OBJECTIVE- To study the knowledge of breast cancer, early detection methods and whomto consult after detecting abnormality among female tertiary health workers.METHOD- This is a descriptive cross-sectional study of 70 female health workers age groupmore than 20 years carried out at various hospitals after taking consent.RESULT- Being majority of young married doctor respondents, below the age of 40 years(81.4%) study was conducted, almost all the respondents are aware of breast cancer, 69(98.5%). Majority of them got information from media (77.1%), followed by seminars(64.2%) and books (62.8%). Only 15.7% of respondents had a positive family history ofbreast cancer. Most participants were aware of BSE and thinks its useful tool (74.3%) butdoesn’t know about proper timing and method for BSE. They have been taught BSE (58.5%)out of which majority were taught by teachers (51.5%). 41.4% and 60% of respondents knewthat BSE should be done monthly and should start after age of 20 respectively. Onerespondent has discovered an abnormality. Respondents are relatively less aware about BSE28 (40%). 45 (64.3%) and 16 (22.9%) think that BSE should be done by a doctor and trainednurse respectively. The level of awareness of sonomammography was high amongrespondents- 43 (57.1%), but only 8 (11.43%) had undergone sonomammography, because of‘not of proper age’ 27 (38.57%).CONCLUSION- Practice and attitude of breast cancer screening should be promoted amonghealth workers and the general population

Evaluation of Palpable Breast Masses by Ultrasound and its Correlation with Tissue Diagnosis in a Tertiary Care Centre in Northern Kerala

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

Evaluation of breast mass and applicability of histopathology and sonomamography for accurate diagnosis of malignant masses

Breast or mammary gland is a modified sweat gland. The mammary gland is a superficial organ. Breast carcinoma is the most common cancer in women all over India and accounts for 25% to 31% of all cancers in women in Indian cities. With the increased incidence of breast cancers every breast lump needs to be evaluated so as to assure the patient of its nature. The study was based on 50 patients who were referred to the Department of Radiodiagnosis and Imaging for evaluation of breast lesions. A detailed breast specific history was taken including menstrual history, history of mastalgia, lactational history, past and family history of any breast problem. Results showed that, highest incidence of breast lesions was found in the age group of 20-29 years containing (36%) of all cases. The second peak was seen in the age group of 40-49 years containing (18%) of all cases. Left sided lesions were slightly more common. While it was observed that of the 50 cases referred ultrasound correctly diagnosed 42% cases as malignant as compared to 18 % diagnosed as malignant by histopathology. The findings of the study potray that Ultrasound (US) should be used as the initial examination in patients and shall also be used as adjuvant to mammography in older patients.

The Study of Different Presentations of Breast Lumps in Radiographic Imaging.

Introduction: Breast USG is an established and accurate tool for the primary evaluation of breast lumps and pathology. It also compliments X- ray mammography in further evaluation and characterization of breast masses and thus avoids surgeries in benign breast diseases and pathology. Method: For USG examination of the breast lumps, a linear-array transducer of 5-7 MHz frequency is required with a good resolution machine. Results: We present a pictorial essay on the role of USG in evaluation and characterization of various breast lumps and pathology. Conclusion: Breast sonography considerably improves the visualization and evaluation of lumps in mammographically radiodense breasts and helpful in the characterization of it, either as solid or cystic lesion. It also improves the specifi city of X-ray mammography when used as an adjunct to it. It is also helpful in guiding FNAC/biopsy from the breast masses.