CORRELATION OF THE HISTOPATHOLOGY OF FOCAL BREAST LESIONS FOUND ON MAMMOGRAPHY WITH STRAIN ELASTOGRAPHY

Abstract

ABSTRACT:

BACKGROUND

Breast cancer is the most common cancer, affecting the women. Early diagnosis and prompt treatment is a crucial part of its management. Mammography combined with B mode ultrasound has high sensitivity and speficity for diagnosing benign and malignant breast masses. However, strain electrography to estimate tissue stiffness can also aid in diagnosis particularly in equivocal cases.

METHODS

Following institutional review board permission, a prospective study was done, analyzing 55 individuals who underwent diagnostic mammography for palpable breast tumors between January 2019 and December 2023. Only BIR
ADS 3 and 4 lesions on mammography were investigated. All of these lumps were examined using ultrasound and strain elastography, with strain ratios calculated for the benign and malignant masses, followed by histopathological correlation.

RESULTS

All 55 lesions were evaluated by histopathology which demonstrated 19 malignant and 36 benign specimens.

Mammography was able to correctly pick 17(89%) of malignant and 16 (40%) of the benign lesions. In comparison strain ratios of 3.1 were taken as benign, with 26 lesions being correctly identified. While strain ratios more than 3.1 were taken as malignant leading to characterization of 29 lesions as malignant, with 15 lesions being correctly identified.

Using mammography alone for BIRADS categorization yielded a sensitivity of 68.4%, specificity of 72%, positive predictive value of 56.5%, and negative predictive value of 81.3%.
However, when strain elastography was used in conjunction with mammography, the sensitivity was 68.4%, the specificity was 75%, the PPV was 59%, and the NPV was 81.8%, indicating that employing both together might help a little in finding solid malignant masses rather than using mammography alone.

CONCLUSION

Strain elastography is an auxiliary approach for enhancing the accuracy and diagnostic yield of conventional mammography in a clinical context, particularly in low suspicion BIRADS 3 and 4 lesions.. This also provides justification in order to prevent unnecessary biopsies which add on to the financial burden superimposed upon the fear of needle in a patient, which can be dealt with followup mammograms instead rather than a heads on aggressive approach.

Key Words: Focal breast lesion; elastography; histopathology; Mammography