Jha Anamika, Lohani Benu
Department of Radiology and Imaging, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
J Nepal Health Res Counc. 2019 Jan 28;16(41):396-400.
With a palpable lesion in the breast, the goal is to diagnose malignancy at the earliest. Ultrasonography is used for evaluating symptomatic patients especially those with dense breasts where mammography gives limited information. The objective of this study was to evaluate the sonographic pattern of the palpable breast lumps and correlate with the final pathological diagnosis.
This was a retrospective study done at our tertiary health care center, from July 2016 to March 2017, including 121 patients presenting to the ultrasound department with complaint of palpable breast lump and whose pathological reports could be followed up. Various sonographic features were studied, sonography and final diagnosis compared.
On sonography, about 46% of the cases were benign, 35 % malignant and 18 % indeterminate while tissue diagnosis revealed 63% to be benign, 34% malignant. The most common lesions in each group and sonographic characteristics were evaluated. Of the benign lesions, fibroadenoma was the most common. Most of the indeterminate lesions on sonography were histologically mastitis. We found nearly 58% of the malignant lesions had microlobulated margins. The sensitivity of sonography was 92.9% and specificity 97.5% with diagnostic accuracy 94.8%.
Most of the palpable lumps were benign in our study, most common being fibroadenoma. We had a relatively higher percentage of malignancy which may be due to patients with obviously benign lesions not undergoing tissue diagnosis in our setting. The sonographic features and diagnosis correlated well with the histological diagnosis.
对于乳房可触及病变，目标是尽早诊断出恶性肿瘤。超声检查用于评估有症状的患者，尤其是那些乳腺致密、乳腺X线摄影提供信息有限的患者。本研究的目的是评估可触及乳腺肿块的超声特征，并与最终病理诊断进行关联。
这是一项在我们的三级医疗保健中心进行的回顾性研究，时间从2016年7月至2017年3月，包括121例因可触及乳腺肿块而到超声科就诊且其病理报告可追踪的患者。研究了各种超声特征，比较了超声检查结果与最终诊断。
在超声检查中，约46%的病例为良性，35%为恶性，18%为不确定，而组织诊断显示63%为良性，34%为恶性。评估了每组中最常见的病变及其超声特征。在良性病变中，纤维腺瘤最为常见。超声检查中大多数不确定病变在组织学上为乳腺炎。我们发现近58%的恶性病变有微叶状边缘。超声检查的敏感性为92.9%，特异性为97.5%，诊断准确性为94.8%。
在我们的研究中，大多数可触及肿块为良性，最常见的是纤维腺瘤。我们的恶性肿瘤比例相对较高，这可能是由于在我们的环境中，明显良性病变的患者未接受组织诊断。超声特征与诊断与组织学诊断相关性良好。
