Study of Using Ultrasonography and Tomosynthesis Criteria of Breast Lesions: Radiologic-Histopathologic Correlation

Abstract

This study aimed to utilize ultrasonography and digital breast tomosynthesis features of breast lesions for characterization and differentiation between benign and malignant and correlate these criteria with histopathological findings.This is prospective hospital base study performed in the breast imaging facility at radiology department, at King Abdul-Aziz Specialist Hospital (KAASH), Taif city, Saudi Arabia during the period from March 2015 to September 2017 included 200 female patients with 227 breast lesions who underwent digital mammography (Selenia Dimensions System; Hologic, Bedford, MA, USA) , ultrasound and ultrasound guided biopsy using a LOGIQ 7 unit (GE Healthcare) with a 12-MHz linear transducer, Core needle biopsy was performed by radiologists under ultrasound guidance using14-gauge Monopty device (Bard, Tempe, AZ) with a 10-cm needle Suros 9-gauge vacuum-assisted CNB biopsy device (Hologic). Data analysed using SPSS version 20. The results of this study revealed that the mean age of the patients was 43 years ranged from 25-82 years. 227 indeterminate (Bi-RADS category 3) or suspicious breast lesions (Bi-RADS category 4 and 5) were found. Of these lesions, 71 were confirmed as malignant and 152 had benign histopathological features.US description of the lesions including mass shape, echo pattern, V margin, boundary, orientation, posterior acoustic features, and calcifications as well as their power Doppler flow criteria are demonstrated. DBT descriptor breast density, nipple retraction, presence of calcification and its shape, architectural distortion and lesion criteria regarding the probability of malignancy, it was determined according to Bi-RADS for all lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the grey scale US, DBT descriptors and power doppler criteria. Taking Bi-RADS category 4 as a cut point, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the lesions estimated Bi-RADS category as an indicator of malignancy. Then, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the lesions combining their Bi-RADS category and presence of penetrating vessels as indicators of malignancy. It concluded that Breast US is a useful diagnostic tool in breast cancer detection and can be used to characterize breast lesions. The vascular flow patterns of breast lesions on PDUS provide additional benefit for the differentiation of benign and malignant breast lesions.