Alotaibi Batool S, Alghamdi Rahaf, Aljaman Sadeem, Hariri Reem A, Althunayyan Lama S, AlSenan Batool F, Alnemer Areej M
Medicine and Surgery, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Pathology, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Cureus. 2024 Jan 7;16(1):e51776. doi: 10.7759/cureus.51776. eCollection 2024 Jan.
Background Breast cancer (BC) remains a significant health concern, leading to illness and death among women globally. It is essential to detect BC early using imaging techniques that accurately reflect the final pathology, guiding suitable intervention strategies. Objectives This study aimed to evaluate the agreement between radiological findings and histopathological results in BC cases. Methods We conducted a retrospective review of breast core needle biopsies (CNBs) in women over a six-year period (2017-2022) at Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. The pathological diagnoses were compared with the findings from preceding radiological investigations. We also compared the tumour sizes in the resection specimens with their radiological counterparts. Results A total of 641 cases were included in the study. Ultrasound (US), mammography, and magnetic resonance imaging (MRI) yielded diagnostic accuracies of 85%, 77.9%, and 86.9%, respectively. MRI had the highest sensitivity at 72.2%, while US had the lowest at 61%. MRI provided the best agreement with the final resected tumor size. By contrast, mammography tended to overestimate the size (41.9%), and US most frequently underestimated it (67.7%). The connection between basal-like molecular subtypes and the Breast Imaging Reporting and Data System (BIRADS)-5 classifications was only statistically significant for MRI (p = 0.04). The luminal subtype was more likely to show speculation in mammography. Meanwhile, BIRADS-4 revealed a considerable number of benign pathologies across all the three modalities. Conclusions MRI demonstrated the highest accuracy, sensitivity, specificity, and positive predictive value (PPV) for diagnosing and estimating the tumor size. Mammography outperformed US in terms of sensitivity and yielded the highest negative predictive value (NPV). US, meanwhile, offered superior specificity, PPV, and accuracy. Therefore, combining these diagnostic methods could yield significant benefits.
背景 乳腺癌（BC）仍然是一个重大的健康问题，在全球范围内导致女性患病和死亡。使用能够准确反映最终病理情况的成像技术早期检测乳腺癌至关重要，这有助于指导合适的干预策略。目的 本研究旨在评估乳腺癌病例中放射学检查结果与组织病理学结果之间的一致性。方法 我们对沙特阿拉伯达曼伊玛目阿卜杜勒拉赫曼·本·费萨尔大学六年期间（2017 - 2022年）女性的乳腺粗针穿刺活检（CNB）进行了回顾性研究。将病理诊断结果与之前放射学检查的结果进行比较。我们还将切除标本中的肿瘤大小与其放射学对应物进行了比较。结果 本研究共纳入641例病例。超声（US）、乳腺X线摄影和磁共振成像（MRI）的诊断准确率分别为85%、77.9%和86.9%。MRI的敏感性最高，为72.2%，而US的敏感性最低，为61%。MRI与最终切除的肿瘤大小一致性最佳。相比之下，乳腺X线摄影往往高估肿瘤大小（41.9%），而US最常低估肿瘤大小（67.7%）。仅MRI显示基底样分子亚型与乳腺影像报告和数据系统（BIRADS）- 5分类之间的关联具有统计学意义（p = 0.04）。管腔亚型在乳腺X线摄影中更可能显示推测性结果。同时，BIRADS - 4在所有三种检查方式中均显示出相当数量的良性病变。结论 MRI在诊断和估计肿瘤大小方面显示出最高的准确性、敏感性、特异性和阳性预测值（PPV）。乳腺X线摄影在敏感性方面优于US，且具有最高的阴性预测值（NPV）。与此同时，US具有更高的特异性、PPV和准确性。因此，联合使用这些诊断方法可能会带来显著益处。
