Journal of Health and Medical Sciences
ISSN 2622-7258
Published: 22 July 2020
Diagnostic Accuracy of Ultrasound in the Detection of Malignant Focal Solid Breast Lesions Taking Biopsy as a Gold Standard
Lina Khaled Jallad, Syed Amir Gilani, Raham Bacha, Asif Hanif, S. Muhammad Yousaf Farooq
University of Lahore, Pakistan
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10.31014/aior.1994.03.03.125
Pages: 302-309
Keywords: Solid Breast Lesion, Breast Cancer, Biopsy, Sonography, Noninvasive Method
Abstract
Background: Now a day’s breast cancer is one of the most common causes of deaths and the most malignant condition among women. Objective: To determine diagnostic accuracy of ultrasound in detection of malignant focal solid breast lesions taking biopsy as a gold standard. Material and methods: This Cross-sectional analytical study was conducted at the department of radiology and pathology of Life Line Hospital. Duration of the study was 9 months after the aproval of synopsis. Ultrasound system (Toshiba Xario) with linear transducer, frequency ranging 7 to 14 MHZ. All 78 participants were scanned while observing international standards of American institute of ultrasound in medicine (AIUM) guidelines for breast sonography. Results: Total 78 females with solid breast lesions were included in this study, out of them 28 (35.90%) were found in right while 50(64.10%) in left side. The distribution of breast lesions in Upper outer quadrant, Lower outer quadrant, Upper inner quadrant, and Lower inner quadrant were 50 (64.10%), 45 (57.49%), 13 (16.67%), 16 (20.51%) and 4 (51.13%) respectively. Mean of the depth to width D/W ration in malignant was 0.78±0.098 (0.42-0.93), while in benign was 0.52±0.141(0.35-0.85). there was a significant difference between the D/W ratio of benign and malignant solid breast lesion. The specificity, sensitivity, positive predictive value, negative predictive value, and diagnostic accuracy of ultrasound while taking histopathology as gold standard were 94.74%, 95.24%, 98.18%, 86.96%, and 94.87% respectively. Conclusion: Ultrasound can differentiate benign and malignant solid breast lesion to a great extent. With the application of this sonographic criteria in the cases of solid breast lesion before biopsy for histologic examination the number of unwanted biopsies will be reduced to a great extent.
References
Rumyantsev, S.N., 2013. Human cancer is a parasite spread via intrusion in genome. Pure and Applied Biology, 2(1), p.7.
Polyak K.,2011 Heterogeneity in breast cancer. The Journal of clinical investigation ,121(10):3786-8.
Almendro, V. and Fuster, G., 2011. Heterogeneity of breast cancer: etiology and clinical relevance. Clinical and Translational Oncology, 13(11), pp.767-773.
MacLennan, M. and Ma, D.W., 2010. Role of dietary fatty acids in mammary gland development and breast cancer. Breast Cancer Research, 12(5), p.211.
Piao, H.L. and Ma, L., 2012. Non-coding RNAs as regulators of mammary development and breast cancer. Journal of mammary gland biology and neoplasia, 17(1), pp.33-42.
Kohler, B.A., Sherman, R.L., Howlader, N., Jemal, A., Ryerson, A.B., Henry, K.A., Boscoe, F.P., Cronin, K.A., Lake, A., Noone, A.M. and Henley, S.J., 2015. Annual report to the nation on the status of cancer, 1975-2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. JNCI: Journal of the National Cancer Institute, 107(6).
DeSantis, C., Ma, J., Bryan, L. and Jemal, A., 2014. Breast cancer statistics, 2013. CA: a cancer journal for clinicians, 64(1), pp.52-62.
Sundquist, J., Riihimaeki, M., Thomsen, H. and Brandt, A., 2012. Death causes in breast cancer patients. Annals of Oncology, 23(3), pp.604-604.
Nelson, H.D., Zakher, B., Cantor, A., Fu, R., Griffin, J., O'Meara, E.S., Buist, D.S., Kerlikowske, K., van Ravesteyn, N.T., Trentham-Dietz, A. and Mandelblatt, J.S., 2012. Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis. Annals of internal medicine, 156(9), pp.635-648.
Berman, A.T., Thukral, A.D., Hwang, W.T., Solin, L.J. and Vapiwala, N., 2013. Incidence and patterns of distant metastases for patients with early-stage breast cancer after breast conservation treatment. Clinical breast cancer, 13(2), pp.88-94.
Gatza, M.L., Lucas, J.E., Barry, W.T., Kim, J.W., Wang, Q., Crawford, M.D., Datto, M.B., Kelley, M., Mathey-Prevot, B., Potti, A. and Nevins, J.R., 2010. A pathway-based classification of human breast cancer. Proceedings of the National Academy of Sciences, 107(15), pp.6994-6999.
Narod, S.A., Iqbal, J., Giannakeas, V., Sopik, V. and Sun, P., 2015. Breast cancer mortality after a diagnosis of ductal carcinoma in situ. JAMA oncology, 1(7), pp.888-896.
Reed, A.E.M., Kutasovic, J.R., Lakhani, S.R. and Simpson, P.T., 2015. Invasive lobular carcinoma of the breast: morphology, biomarkers and’omics. Breast cancer research, 17(1), p.12.
Siponen, E., Hukkinen, K., Heikkilä, P., Joensuu, H. and Leidenius, M., 2010. Surgical treatment in Paget's disease of the breast. The American Journal of Surgery, 200(2), pp.241-246.
Sabel MS. Clinical manifestations, differential diagnosis, and clinical evaluation of a palpable breast mass.275.
Dyrstad, S.W., Yan, Y., Fowler, A.M. and Colditz, G.A., 2015. Breast cancer risk associated with benign breast disease: systematic review and meta-analysis. Breast cancer research and treatment, 149(3), pp.569-575.
Fatima, K., Masroor, I. and Khanani, S., 2018. Probably benign solid breast lesions on ultrasound: Need for biopsy reassessed. Asian Pacific Journal of Cancer Prevention: APJCP, 19(12), p.3467.
Naz, S., Hafeez, S., Hussain, Z. and Hilal, K., 2017. Negative predictive value of ultrasound in predicting tumor-free margins in specimen sonography. Journal of the College of Physicians and Surgeons--Pakistan, 27(12), p.747.
Murad, M. and Bari, V., 2004. Ultrasound differentiation of benign versus malignant solid breast masses. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP, 14(3), pp.166-169.