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Background: Breast cancer is the most common female cancer worldwide representing nearly a quarter (25%) of all cancers with an estimated 1.67 million new cancer cases diagnosed in 2012.This study was designed with the primary aim to compare the difference between MRI and Mammography in patients presenting with breast related complaints. Methods: This prospective study was conducted between Oct 2006 and Feb 2008 in the department of Radio diagnosis & Imaging at Army Hospital (Research & Referral), Delhi Cantt. Fifty patients screened with suspicious malignant breast lesions were taken up for the study. Results: Mammography Imaging revealed that most of the malignant masses were found to have architectural distortion & calcification with fewer cases of skin involvement, PI& Nipple retraction respectively. Benign masses were diagnosed with comparatively fewer cases of calcification and presence of other morphological features was rare. Various Imaging techniques have been compared with the Histopathology gold standard technique, When compared with USG Our study showed the sensitivity, specificity, PPV,NPV& Accuracy 67%,75%,80%,72%. Conclusion: Mammography compared to DCMRI has shown to produce false negative results, especially showing less sensitivity for diagnosis of breast cancer in younger women having dense breast
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Aim: To evaluate the role of chromohysteroscopy in detection of intracavitary lesions in perimenopausal women with abnormal uterine bleeding. Methods: This was a prospective study conducted in 100 perimenopausal women with AUB who underwent transvaginal sonography, conventional hysteroscopy and chromohysteroscopy. Atotal of 34 cases in our study group underwent hysterectomy and specimens were sent for histopathology. Histopathological examination was carried out by a clinical pathologist who was blinded regarding hysteroscopic findings. Diagnostic accuracy of hysteroscopy and chromohysteroscopy in detection of intracavitary lesions was then studied keeping histopathology as the gold standard.Results: 2Mean age of the study group was 43.49 ± 3.42yrs, average parity was 3 and mean BMI was 25.41± 3.41 Kg/m. 40% cases presented with menorrhagia, 38% with polymenorhagia, 9% with metrorrhagia and 4% with postmenopausal bleeding. Hysteroscopy revealed normal cavity in 59 cases, intracavitary lesions were detected in 26 cases (submucous fibroids in 14, endometrial polyps in 11, and growth with areas of necrosis in one case), synechiae in 2 cases and diffuse endometrial disease was suspected in 17 cases (hyperplastic in 13 cases and polypoidal in 4 cases. On chromohysteroscopy, most of the intracavitary lesions (72%) either did not stain or the uptake was very minimal giving an unstained appearance in comparison to the surrounding endometrium. The lesions thus got demarcated and separated from the surrounding endometrium. The conventional hysteroscopic, chromohysteroscopic and histopathologic findings were then compared with each other. The diagnostic accuracy of conventional hysteroscopy in detecting polyps was found to be high (Sensitivity-85.71 %, specificity- 92.59%, positive predictive value- 75.0%, negative predictive value- 96.15% ; P<0.001). Its diagnostic accuracy in detecting submucous fibroids was also high (Sensitivity-92.31 %, specificity- 90.47%, positive predictive value 85.71%, negative predictive value- 95.00 %;(P<0.001). The diagnostic accuracy of chromohysteroscopy in detecting intracavitary lesions as unstained areas was also found to be significantly high (Sensitivity-80.0 %, specificity- 78.57%, positive predictive value- 84.2%, negative predictive value- 73.34% ; (P<0.01).Conclusion:The diagnostic accuracy of both hysteroscopy and chromohysteroscopy in detecting intracavitary lesions is high. However, differential staining on chromohysteroscopy made these lesions look more prominent and easily identifiable to the observer.