Annals of medicine and surgery (2012) · 2025
Evaluation of the diagnostic accuracy of mammography and ultrasonography for breast cancer diagnosis using histopathology as the reference standard: a cross-sectional study.
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Alotaibi Sultan A, Gareeballah Awadia, Sami Ur Rahman Jawwad, Faqihi Wael A, Ali Sara, Elbashir Meaad, Haj Nisreen, Sharief Abdulrhman Kawthar Mohammed, Abouraida Ahmed Raga Ahmed, Hazazi Ahmed, Ali Babar
Аннотация
BACKGROUND AND AIM: Breast cancer remains the most common malignancy and the leading cause of cancer-related death among women globally, especially in low- and middle-income countries. Early and accurate diagnosis is critical to improving survival outcomes. This study compares the diagnostic accuracy of ultrasonography and mammography in detecting breast carcinoma, using histopathology as the gold standard.
METHODS: A cross-sectional descriptive study was conducted in a radiology department at a tertiary care hospital, including 240 female patients presenting with clinically palpable breast lesions. Each participant underwent both mammography and ultrasonography prior to biopsy. Data collection included lesion characteristics, imaging findings, and histopathological results. Diagnostic performance was evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.
RESULTS: Ultrasound demonstrated a consistent diagnostic accuracy of 86.3% in both breasts, with high NPVs (≥95.7%) and good sensitivity in dense tissue. Mammography showed variability between sides: accuracy was 81.7% on the right and 94.6% on the left, with left-sided sensitivity reaching 100%. Ultrasound was more effective in identifying hyperechoic lesions and smooth margins, while mammography was superior in detecting calcifications and architectural distortions. Statistical testing confirmed significant associations (P < 0.001) for all modality comparisons with histopathology.
CONCLUSION: This study highlights the complementary diagnostic value of ultrasonography and mammography in the evaluation of breast carcinoma. Ultrasound demonstrated consistent diagnostic accuracy and strong NPV, making it particularly valuable in premenopausal women and those with dense breast tissue. Mammography, on the other hand, showed superiority in detecting microcalcifications and subtle architectural distortions, underscoring its indispensable role in identifying ductal carcinoma in situ and early-stage malignancies.
METHODS: A cross-sectional descriptive study was conducted in a radiology department at a tertiary care hospital, including 240 female patients presenting with clinically palpable breast lesions. Each participant underwent both mammography and ultrasonography prior to biopsy. Data collection included lesion characteristics, imaging findings, and histopathological results. Diagnostic performance was evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.
RESULTS: Ultrasound demonstrated a consistent diagnostic accuracy of 86.3% in both breasts, with high NPVs (≥95.7%) and good sensitivity in dense tissue. Mammography showed variability between sides: accuracy was 81.7% on the right and 94.6% on the left, with left-sided sensitivity reaching 100%. Ultrasound was more effective in identifying hyperechoic lesions and smooth margins, while mammography was superior in detecting calcifications and architectural distortions. Statistical testing confirmed significant associations (P < 0.001) for all modality comparisons with histopathology.
CONCLUSION: This study highlights the complementary diagnostic value of ultrasonography and mammography in the evaluation of breast carcinoma. Ultrasound demonstrated consistent diagnostic accuracy and strong NPV, making it particularly valuable in premenopausal women and those with dense breast tissue. Mammography, on the other hand, showed superiority in detecting microcalcifications and subtle architectural distortions, underscoring its indispensable role in identifying ductal carcinoma in situ and early-stage malignancies.