Role of clinical examination and ultrasound in detecting in the size of breast lump and its corelation with pathological specimen size

ABSTRACT

To assess and compare the role of clinical examination and ultrasound in detecting the size and nature of breast lump in relation to gross pathological specimen size. Retrospective case review analytical study which was conducted in Ward-26, Jinnah Postgraduate Medical Centre, Karachi over a period of two years i.e. September, 2002 to September 2004. All female patients visited outpatient department of Ward-26 with definitive breast lump above 12 years of age were included. Fifty eight patients age ranging froni 15 - 60 years were scanned in study. Out of which 35 patients [60.3%] turned out to be benign and 23 [39.6%] patients malignant cases. The sensitivity and specificity of ultrasonography and clinical examination for benign lesion is 100% but in case of malignant disease the specificity of ultrasonography is 95.7% i.e. in one case ultrasonography did not detect the malignant condition. The digital examination and ultrasonography found comparable and correlated best with gross histopathological specimen in case of benign condition while in case of malignant lesion, tumor size assessed clinically depicted a stronger correlation [r=0.9] with pathological findings while ultrasonography underestimated 6 cases out of 23. Gold standard criteria of histopathological diagnosis confirmed that physical examination measurement remains the method of choice in evaluating the disease preoperatively. The role of ultrasonography in benign lesion is undoubtful but prediction of pathological outcome is not improved by ultrasonography in malignant conditions. The combination of physical examination with ultrasonography significantly improves the accuracy of non-invasive assessment of tumor dimensions