Evaluation of Clinically Palpable Breast Lumps with Digital Mammography, Sonography and Fnac: Case Study

Breast cancer is the second leading cause of cancer deaths in women today (After lung cancer) and is the most common cancer among women, excluding non-invasive non-melanoma skin cancers. Worldwide, breast cancer comprises 22.9% of invasive cancers in women and 16% of all female cancers.1 Mammography has been the basic imaging method in breast diagnostics, and the only tool suitable for screening.2 breast cancer Mammography is still the first line of the imaging investigation. USG has emerge as the most important adjunct to mammography in patients with breast lumps and normal or inconclusive mammographic findings. This is the prospective study on 50 patients reporting with complaints of breast lump in surgical OPD at Mahatma Gandhi Hospital, Sitapura, Jaipur. INTRODUTION: Worldwide, breast cancer comprises 22.9% of invasive cancers in women and 16% of all female cancers (WHO, 2008). According to an Indian health news report, one in 22 women’s in India is likely to suffer from breast cancer during their life time. The figure is definitely more in America with one in eight being a victim of this deadly cancer.3 However the incidence of breast cancer is rising in every country of the world especially in developing countries such as India, especially in metropolitan cities. This is because more and more women in India are beginning to work outside their homes which allow the various risk factors of breast cancer to come into play. Mammography & sonomammography are widely used for the radiological evaluation of breast lumps. Both these procedures can be used individually or in adjunction to each other for the detection of nature (benign or malignant) of breast lump. Mammography has been the basic imaging method in breast diagnostics, and the only tool suitable for screening breast cancer (Tabár et al. 2000). Mammography is still the first line of the imaging investigation. The aim of interpreting mammograms is to find asymmetric densities, mostly circular or stellate lesions; parenchymal contour changes; architectural distortion and micro calcifications with or without associated tumor, which may indicate breast malignancy.4 The sensitivity and specificity of mammography in detecting breast cancers are highly dependent on the composition of the breast parenchyma. Detection of cancer is difficult in patients with dense breast parenchyma (young, pregnant or lactating patients and patients on HRT) and mammographically non calcified tumours. A definite differentiation between cyst and tumours is also not possible in most of the cases. In response to these diagnostic deficiencies of mammography various modalities have been evaluated for the diagnosis of the breast cancer, including light-scanning, thermography, ultrasonography (US), isotope scanning, digital subtraction angiography, computed tomography and MR imaging, USG and MR being the most reliable of these. DOI: 10.14260/jemds/2015/372 CASE REPORT J of Evolution of Med and Dent Sci/ eISSN2278-4802, pISSN2278-4748/ Vol. 4/ Issue 15/ Feb 19, 2015 Page 2596 The greater availability, cheapness and low technical requirements have made USG to emerge as the most important adjunct to mammography in patients with breast lumps and normal or inconclusive mammographic findings. AIM OF STUDY: to evaluate clinically palpable breast lumps with digital mammography, sonomammography and FNAC and to assess the sensitivity, specificity and positive predictive values of digital mammography, sonomammography in detecting carcinoma of breast. The specificity to diagnose malignant versus benign by various imaging modalities will be tested and confirmed based on histopathological reports. EXLUSION CRITERIA: we have excluded pregnant women and Patients with bleeding diathesis.