ACCURACY OF ULTRASOUND IN DETECTING PALPABLE SOLID BREAST MASSES

Abstract

This study aimed to determine the validity of ultrasound in the assessment of the palpable breast mass by determining the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound in distinguishing a malignant mass. To determine the most discriminating ultrasound characteristics for differentiating benign and malignant nodules in an attempt to avoid unnecessary biopsies .Quantitative cross section retrospective design was employed in a study population which consisted of all women over the age of 35 who came to well women clinic in Mother and Child health Care Centre in Sharjah , complaining of palpable mass and took part in mammographic , ultrasound screening & had a proved solid palpable breast mass histologically.Sixty five patients who had biopsy of a palpable breast mass were subjected to an ultrasound assessment of the mass. The ultrasound findings were classified as probably benign, indeterminate or malignant. These findings were then compared with histology results. The age of the patients ranged between 35 and 63 years the majority of patients (68.6%) were in the third and fourth decades . The ultrasound findings had detected 27 (41.53%) out of 30 malignant lesions. All of these were confirmed malignant on histopathology and none of these cases were benign. Ultrasound had a sensitivity of 100%, specificity of 46.66%, positive predictive value of 69%, negative predictive value of 100% and accuracy of 75% for distinguishing a palpable solid malignant mass from benign masses. Main benignancy criteria were: well defined shape, regular contour, homogeneous echo texture, and horizontal orientation. While Irregular shape, indistinct margins, vertical orientation and tissue distortion were powerful indicators for malignancy.