Study aimed to evaluate and compare the performance of ultrasound, ultrasound elastography and magnetic resonance imaging in the diagnosis of breast cancer & its differentiation from benign lesions
Material & Method: This cross-sectional observational study was conducted at department of Radiodiagnosis, Era’s Lucknow Medical college. The study was conducted for 18 month from January 2019 to june 2020. Patients detected with breast lesions and willing to be part of study were included in the study. The patients with cystic nodules and non-consenting patients were excluded from the present study. All the patients were subjected to B-mode USG assessment followed with Real Time ultrasound Elastography and 0.5 Tesla MRI scan. Fine needle aspiration cytology (FNAC) or biopsy was performed and the specimen were evaluated cytologically/histopathologically to confirm the diagnosis
Result: Histopathologically, 18 (36%) cases were diagnosed as malignant and remaining 32 (64%) were diagnosed as benign. Among 18 malignant cases, maximum (n=11) were intraductal carcinoma (NOS), followed by well-differentiated intraductal carcinoma (n=6) and invasive lobular carcinoma (n=1) respectively. Among 32 benign cases, maximum (n=20) were fibroadenoma, followed by breast abscess (n=3), galactocele, intraductal papilloma and simple cyst (n=2 each). There was 1 case each diagnosed as fibroadenolipoma, fibrocystic and phyllode respectively. Diagnostic efficacy of USG in terms of sensitivity, specificity, positive and negative predictive value was 77.8%, 87.5%, 77.8% and 87.5% respectively. The accuracy of USG diagnosis was 84%. Diagnostic efficacy of USG elastography in terms of sensitivity, specificity, positive and negative predictive value was 83.3%, 96.9%, 93.8% and 91.2% respectively. The accuracy of elastography diagnosis was 92%. Diagnostic efficacy of MRI in terms of sensitivity, specificity, positive and negative predictive value was 94.4%, 90.6%, 85.0% and 96.7% respectively. The accuracy of MRI diagnosis was 92%.
Conclusion: In low-resource settings, USG elastography can emerge as a suitable alternative to MRI in diagnosis of malignant breast masses with highly appreciable positive and negative predictive values.
Study Design: Observational Study.