DIAGNOSTIC ACCURACY OF MAMMOGRAPHY AND ULTRASOUND IN DETECTION OF BREAST LESIONS: A PROSPECTIVE CROSS-SECTIONAL STUDY
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Keywords
Breast Cancer, Mammography, Ultrasonography, Diagnostic Accuracy, BI-RADS Classification
Abstract
Breast cancer remains the leading malignancy among women globally, with early detection significantly improving outcomes. While mammography is the established screening modality, its sensitivity decreases in dense breasts, particularly prevalent in Asian populations. This study aimed to evaluate and compare the diagnostic accuracy of mammography and ultrasound for breast lesion detection using histopathology as the gold standard.
Methods: A prospective observational cross-sectional study was conducted at Saraswathi Institute of Medical Sciences, Anwarpur, Uttar Pradesh, from July 2022 to December 2022. A total of 148 female patients with clinically detected breast abnormalities underwent both digital mammography and high-resolution ultrasound. All lesions were categorized using BI-RADS classification and subsequently confirmed through histopathological examination. Diagnostic performance parameters including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for both modalities individually and in combination.
Results: Of 148 lesions, 64 (43.2%) were malignant and 84 (56.8%) were benign on histopathology. Mammography demonstrated sensitivity of 84.4%, specificity of 81.0%, and accuracy of 82.4%. Ultrasound showed sensitivity of 90.6%, specificity of 73.8%, and accuracy of 81.1%. Combined modalities achieved superior diagnostic accuracy of 90.5% with sensitivity of 96.9% and specificity of 85.7% (p<0.001). Ultrasound performance was less affected by breast density and age compared to mammography, showing consistent sensitivity across subgroups.
Conclusion: Combined mammography and ultrasound significantly improves breast lesion detection accuracy compared to either modality alone, particularly in younger women with dense breasts. This combined approach should be standard protocol for evaluating symptomatic breast lesions in populations with high breast density prevalence.
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Dr Mukesh Khatri
Assistant Professor, Department of Radio-Diagnosis, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India.
