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Volume 1 | Issue 1 | January - June 2017

Diagnostic association of mammographic suspicious breast lesions with cytology and histopathology: a tertiary cancer center experience from India 

Article 4, Volume 1, Issue 1, Jan-June 2017, Page 8-15   PDF Download

Type : Orignal  Artical

Author : Abhishek Shankar¹* , Abhijit Chakraborty3 , Veronika Bentrad4 , Shubham Roy5 , Vipin Kharade2 , Rashi Kulshrestha6 , Goura Kishor Rath2

1Department of Preventive Oncology, Dr. B.R.Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical sciences, Delhi, India

2Department of Radiation Oncology, Dr. B.R.Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical sciences, Delhi, India

3Dept. of Clinical Research, Netaji Subhas Chandra Bose Cancer Research Institute, Kolkata, India

4Department of Biochemistry and Onco-pharmacology, R.E. Kavetsky Institute of Experimental Pathology, Ukraine

5Department of Pediatrics, Max Smart Super specialty Hospital, Delhi, India

6Department of Radiation Oncology, Maulana Azad Medical College, Delhi, India

 

Abstract

Background: Breast cancer is recognized as the commonest cancer in females worldwide. Triple assessment is a very useful diagnostic tool to evaluate patients with breast lumps and to detect patients with breast cancers with high accuracy. This is a study to see the correlation of suspicious breast lesions on mammography with cytology and histopathology.

Methods: Suspected women with breast cancer attending the oncology department underwent complete evaluation in form of clinical history and examination. Selected women after clinical examination underwent a mammography. All lesions with BIRADS categorization of 2 and above underwent FNAC and biopsy for histological diagnosis. Pathological reports were collected and data was entered in computer and analysed.

Results: Over a period of 1 year, 100 patients with symptomatic breast lesion were included in this study and cancer diagnosis was confirmed based on radiological and pathological tests. The mean age of patients was 51.67 years (range of 35-74 yrs). Among all patients, 66% were postmenopausal and 44% were premenopausal. Most common finding was mass lesions (54%) followed by mass with micro-calcifications (19%). Out of the 100 biopsies done, 59% were benign lesion and 41% were malignant. The most common benign pathological diagnosis was fibrocystic disease and fibroadenoma. Patients with BIRADS 4 and 5 on mammography were found to have malignant lesions after cytology and histopathology in 85% of cases. Further analysis indicated that the Positive Predictive Value (PPV) for BIRADS 5 is 100%.

Conclusions: The use of BIRADS categorization does improve the quality of risk assessment information and it is useful in predicting the chance of malignancy and also in avoiding unnecessary biopsy. Our analysis of biopsy modalities illustrated that core needle biopsy is preferred to excision biopsy for optimal diagnosis and management of radiographically detected lesions.

 

Keywords: Breast lesions; Mammography; Cytology; Histopathology

 

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