Rishav Prasad1, Guddakesh Kumar2, Prashant Sinha3, Dipu Singh4
BACKGROUND
In clinical practice, breast lump is a very common presentation of numerous breast
diseases which ranges from benign cysts to malignant lesions. The difference
between benign and malignant is very important for patient care and proper
management. The diagnosis of breast lump includes clinical examination
supplemented by imaging. Various literature has concluded that ultrasound
evaluation with fine needle aspiration cytology (FNAC) correlation has comparable
sensitivity and specificity to histopathology. Our aim was to study the ultrasonographic
characteristics of breast lesions in patients and compare the
sensitivity of ultrasonography in diagnosing benign and malignant breast lesions
with FNAC.
METHODS
This is a diagnostic validation study, conducted at Department of Radiodiagnosis
and Department of Pathology, Narayan Medical College and Hospital. All females
more than 30 years coming for routine breast screening, found to have Breast
Imaging Reporting and Data System (BI-RADS) 2 and above were subjected to
ultrasonography and FNAC under ultrasonography (USG) guidance, and compared
with histopathology. Data was collected, entered and analysed using Microsoft
Excel, Epi Info, and SPSS software. Sensitivity and specificity with correlation,
positive predictive value (PPV), negative predictive value (NPV) was calculated to
compare the two diagnostic modalities.
RESULTS
USG had 83.3 % sensitivity, 97.56 % specificity, 95.24 % positive predictive value,
90.91 % negative predictive value, 33.32 % positive likelihood ratio and 17.13 %
negative likelihood ratio. FNAC had 96.67 % sensitivity, 97.56 % specificity, 96.67
% positive predictive value, 97.56 % negative predictive value, 38.66 % positive
likelihood ratio and 3.42 % negative likelihood ratio.
CONCLUSIONS
Breast ultrasound and FNAC both are important diagnostic tools for breast lesion.
Sensitivity, specificity and other features are better for FNAC than ultrasound for
breast lump.
