Diagnostic efficacy of physical examination and radiological findings in palpable breast masses

Öz

Aim: Clinical breast examination (CBE) is important in the early diagnosis of breast cancer, especially in low- and middleincome countries. Tru-cut biopsy (TCB) is the most used method for pathological diagnosis in patients with breast mass. This study aimed to evaluate the advantages and diagnostic accuracy of TCB decision based on CBE in patients presenting with a breast mass. Material and Methods: In this prospective cohort study, the data of patients who admitted to our outpatient breast clinic between September 2020 and March 2021 were evaluated. The presenting complaints, family history, hormone replacement treatment, mass size, contour, mobility, radiological findings, BI-RADS classification, and pathological diagnosis of TCB were recorded. Two hundred- two patients who underwent TCB in our outpatient breast clinic were included in the study. Results: The presence of irregular and fixed mass was mainly observed in the malignant group compared to the benign group (67.1% vs 43.9%, P: 0.001; 75.9% vs 39%, P< 0.001, respectively). In regression analysis, age was significantly associated with breast malignancy (OR: 1.12, CI %95: 1.06-1.18). CBE showed 85.5% consistency for benign pathology, 88.5% for malignancy, and 90.2% for granulomatous breast mass. Conclusion: The patients in advanced age and postmenopausal condition with irregularly, fixed breast mass in physical examination should be considered at high risk for breast cancer. TCB should be performed by experienced surgeons in lowmiddle-income countries and the diagnosis should be reached by reducing the long time and cost caused by radiology.

Anahtar Kelimeler

• Breast cancer
• Breast mass
• Clinical breast examination
• Tru-cut biopsy.

Palpabl meme kitlelerinde fizik muayene ve radyolojik bulguların tanısal gücü

Öz

Amaç: Klinik meme muayenesi (KMM), özellikle düşük ve orta gelirli ülkelerde meme kanserinin erken tanısında önemlidir. Tru-cut biyopsi (TCB), meme kitlesi olan hastalarda patolojik tanı için en sık kullanılan yöntemdir. Bu çalışmada meme kitlesi ile başvuran hastalarda KMM'ye dayalı TCB kararının avantajlarını ve tanısal doğruluğunu değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu prospektif kohort çalışmada, meme polikliniğimize Eylül 2020 ile Mart 2021 tarihleri arasında başvuran hastaların verileri değerlendirildi. Başvuru şikayetleri, aile öyküsü, hormon replasman tedavisi, kitle boyutu, kontur, mobilite, radyolojik bulgular, BI-RADS sınıflaması ve TCB'nin patolojik tanısı kaydedildi. Çalışmaya meme polikliniğimizde TCB uygulanan toplam 200 hasta dahil edildi. Bulgular: Malign grupta düzensiz ve fikse kitle varlığı Benign gruba kıyasla daha fazla gözlendi (sırasıyla %67.1'e %43.9, P: 0.001; %75.9'a %39, P< 0.001). Regresyon analizinde yaş, meme malignitesi ile anlamlı olarak ilişkiliydi (OR: 1.12, CI %95: 1.06- 1.18). KMM, benign patoloji için %85,5, malignite için %88,5 ve granülomatöz meme kitlesi için %90,2 tutarlılık gösterdi. Sonuç: Fizik muayenede düzensiz sınırlı, fikse meme kitlesi saptanan ileri yaş ve postmenopozal hastalar meme kanseri görülmesi açısından yüksek riskli kabul edilmelidir. TCB, düşük-orta gelirli ülkelerde deneyimli cerrahlar tarafından uygulanmalı ve radyolojinin neden olduğu zaman kaybı ve maliyet azaltılarak kısa sürede tanıya ulaşılmalıdır.

Anahtar Kelimeler

• Meme kanseri
• Meme kitlesi
• Klinik meme muayenesi
• Tru-cut biyopsi.

Kaynakça

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