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Abstract
ULTRASOUND ROLE IN EVALUATING PALPABLE BREAST LUMP IN FEMALE PATIENTS ATTENDING AL-ELWEIYA MATERNITY TEACHING HOSPITAL IN IRAQ
Rafif Nemah Hassoni*, Hiba Dhari Al Ameri and Besmah Mohammed Ali
ABSTRACT
Introduction: Breast lump is a common presenting symptom in women; lumps pose a potential threat to women especially in the era of increased cases of breast cancer worldwide. In Iraq there is increase in incidence rate of breast cancer with trend to affect young women. Different tools used for early detection of breast masses; ultrasound (US) playing an increasingly vital role. A major advantage of US is ability to direct correlate the clinical and imaging finding and for assessment of possible masses after mammography. Ultrasound is feasible, low-cost and, easily accepted. Objectives: The study was conducted to find the role of ultrasound in diagnosing palpable breast lumps among women attending Al-Elweiya Maternity Teaching Hospital. Methods: A cross-sectional study conducted o 150 cases of palpable breast masses are evaluated by US in Al Elweiya Maternity Teaching Hospital between March to October 2021. By using US criteria, a mass then classified according to BI-RADS (Breast Imaging-Reporting and Data System) which is a risk assessment and quality assurance tool developed by ACR (American College of Radiology). Results: Out of 150 women most of patients 27%were in (40-49) years age group. Benign breast lumps account for 99 (66%) and 51 (34%) breast lumps were malignant. There was significant association between malignant breast lump and age group 50-59 years (33%, P=0.001). Ultrasound showed 96.07% accuracy in detecting malignant lump with good sensitivity, specificity, positive predictive value (PPV) and, negative predictive value (NPV) (90.2%, 97.0%,93.87%,95%) respectively. Malignant lumps significantly associated with US features; irregular, uncircumscribed, shadowing and not parallel orientation (92.2%, 94.1%, 66.7% and 100.0% with P value = 0.001) respectively. Conclusion: Ultrasound has high diagnostic accuracy, so it is highly reliable in detecting breast abnormalities when strict diagnostic criteria are met especially mass shape, margin, orientation, and posterior features. Breast cancer affect one third of women with trend to affect young. Based on this evidence using US as first line screening program especially in young women or as adjunct to mammogram is recommended; Although further studies to evaluate the cost effectiveness of ultrasound to be used as first screening modality are needed.
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