الفهرس | Only 14 pages are availabe for public view |
Abstract Breast cancer remains one of the leading causes of death in women over the age of 40 years. Women at this age have extensive breast density which are doubly disadvantaged as they are both at higher risk of developing breast cancer and at greater risk that cancer will not be detected because of masking of the radiological signs of cancer by increased density, therefore diagnosis of breast carcinoma is complex and requires multiple imaging modalities. This thesis aimed to the impact digital mammography and breast ultrasonography in the detection and diagnosis of mass lesions in the dense breasts. In this study, the mean age of the studied group was 38 years so mammographic results might not be significant in this population because mammography has limitations in detection of cancer in the dense breast tissue. To overcome this limitation, additional imaging modality is often needed for sound diagnosis. Ultrasound has been proved earlier that it is more effective for diagnosis of breast lesions in women younger than 35 years of age and denser the breast parenchyma . Our study included 100 patients with 92 breast lesions.All patients performed Mammography and Breast ultrasound. The final diagnosis according to mammography morphology descriptors revealed 72/100(72%) lesions were considered benign and 28/100(28%) lesions were considered malignant while he final diagnosis according to ultrasound morphology descriptors revealed 64/100 (64%) lesions were considered benign and 36/100(36%) lesions were considered malignant In this study, mammography had a sensitivity of 40%, a specificity of 93%, a positive predictive value of 80%, a negative predictive value of 70% and diagnostic accuracy 72% , ultrasound had a sensitivity of 90%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 94% and diagnostic accuracy 96% while combined mammography with breast ultrasound reveled sensitivity 100%,specificity 93%,positive predictive value 91% negative predictive value 100% and accuracy96%. The sensitivity, specificity and accuracy obtained by ultrasound alone and in combination with mammography is better than the sensitivity , specificity and accuracy of mammography alone . In Conclusion: Mammography can stratify breast density to dense and non-dense breasts. However, ultrasonography should be considered as an important screening and diagnostic adjunct to mammography to minimize the chances of missing diagnosis of any dense breast lesions. |