The Value of Adding Ultrasound in the Diagnosis of Breast Mass

Öz

Background: Mammography has been used widely for breast cancer screening. However, the false-negative rate of mammography is 35%. Breast ultrasonography (USG) is the most common method used for additional screening. Performing routine breast ultrasonography (USG) with mammography is still a matter of debate. In our study, it has been aimed to determine the value of adding breast ultrasonography (USG) on the suspicious breast masses.

Material and Methods: In our study, 121 breast lesions were evaluated in 104 patients. Files and images of patients were analyzed retrospectively. Patients who underwent mammography and ultrasound imaging were included in the study. Lesions were categorized in accordance with the Breast Imaging Reporting and Data System (BIRADS) classification. Patients were divided into two groups (under and above 45 years of age), and sensitivity and specificity rates of mammography and USG were compared.

Results: Mammography of 27 patients with malignant masses was reported as BIRADS 1, 2 and 3, respectively and nothing was mentioned about malignant masses. Breast ultrasonography (USG) was not able to detect the malignant masses in 9 patients. Three patients were detected as false-positive in the breast ultrasonography (USG). patients were divided into two groups as; those older than 45 and younger than 45, were divided into two groups; it has been observed that patients who are under 45 are more sensitive, and mammography is more specific for the other group, who are above 45 years old (p<0.05). There was a significant difference between the groups that have Type 1 and 2 breast pattern and Type 4 breast pattern in terms of mammographic sensitivity rates (p<0.05).

Conclusion: Breast ultrasound is more sensitive in demonstrating malignant breast masses. Mammography is more specific for patients above 45 years of age. Breast density is the most important factor in determining the sensitivity of mammography. However, sensitivity and specificity will increase with additional screening methods such as breast ultrasonography (USG) and MRI. 

Anahtar Kelimeler

• Mammography; Ultrasonography; Breast cancer

MEME KİTLELERİNİN TANISINDA ULTRASONOGRAFİ EKLENMESİNİN DEĞERİ

Öz

Amaç: Mamografi meme kanseri taramasında yaygın olarak kullanılmasına ragmen yanlış negatiflik oranı %35 dir. Meme Ultrosonografisi en sık kullanılan ek tarama metodudur. Mamografi ile birlikte rutin meme usg’si yapılması halen tartışmalıdır. Çalışmamızda şüpheli meme kitlelerinde meme USG eklenmesinin değerini belirlemek amaçlanmıştır.

Gereç ve Yöntemler: Çalışmamıza 104 hastadaki toplam 121 meme lezyonu değerlendirildi. Mamografi ve ultrasonography (USG) görüntüleme yapılan hastalar çalışmaya dahil edildi. Lezyonlar Breast Imaging Reporting and Data System (BIRADS) sınıflamasına gore categorize edildi. Hastalar 45 yaş altı ve üstü olarak iki gruba ayrılarak mamografi ve ultrasonography (USG)’nin sensivite ve spesifite oranları karşılaştırıldı.

Bulgular: Malign kitlesi olan 27 hastanın mamografileri BRIADS 1,2 ve 3 olarak raporlandı. Malign kitlelerden bahsedilmedi. Meme ultrasonography (USG) 9 hastada malignite taşıyan kitleyi saptayamadı. Meme ultrasonography (USG) ile 3 hastada yanlış pozitiflik saptandı. Hastalar 45 yaş altı ve üstü olarak iki gruba ayrıldığında meme ultrasonography (USG)’sinin 45 yaş altı grupta daha duyarlı olduğu, mamografininise 45 yaş üstünde daha spesifik olduğu bulundu (p<0,05) Tip 1 ve 2 meme paternine sahip grup ile tip 4 meme paternine sahip gruplararasında mamografinin duyarlılık oranlarında istatistiksel anlamlılık saptandı (p<0,05).

Sonuç: Meme ultrasonography (USG)’si memedeki malign kitleleri göstermede daha duyarlıdır. 45 yaşın üzerindeki hastalarda mamografi daha spesifiktir. Meme yoğunluğu mamografinin duyarlılığını belirlemede önemli etkendir. Ancak meme ultrasonography (USG) ve MRI ile ek görüntülemelerde duyarlılık ve spesifitede artış olacaktır. 

Anahtar Kelimeler

• Mamografi
• Ultrasonografi
• Meme kanseri

Kaynakça

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