The Accuracy of Ultrasound in Diagnosis of Palpable Breast Lumps.

ABSTRACT

To find the sensitivity, specificity and positive predictive value of ultrasound in detection of palpable breast lumps and to correlate the findings of ultrasound with the findings of fine needle aspiration cytology (FNAC), or histopathology. Ultrasonagraphic evaluation of 100 palpable breast lumps was done in our institute in the department of radiology. Diagnosis was made considering four features of the lumps i.e. shape, margins, width AP ratio and echogenicity. Diagnosis was confirmed by fine needle aspiration cytology or histopathology.The sensitivity of ultrasound in detection of palpable breast lumps was 95%. The incidence of breast lumps was highest in the age group of 20-29 years. Lump alone was the presentation in 78% of the cases. 54% of the lumps were present in outer upper quadrant of the breast. The sensitivity, specificity and positive predictive value of ultrasound in fibroadenoma of the breast was 81.6%, 94.7% and 91.2% respectively. The sensitivity for carcinoma of the breast was 65% and for cystic masses it was 92%. The ultrasound features that most reliably characterized breast masses as benign were round or oval shape (95% were benign), circumscribed margins (86% were benign) and width AP ratio > 1.4 (87% were benign). Features that characterised masses as malignant were irregular shape (47% were malignant), non-circumscribed margins (41% were malignant) and width AP ratio 1.4 (39% were malignant).Ultrasound is a useful tool in differentiation of cystic from solid masses of the breast. It is useful in young females and pregnant women where mammography is not advisable. However its role in diagnosis of carcinoma of the breast needs further evaluation before it can be used for screening of carcinoma breast.