Evaluation of breast diseases by clinico-pathological and radiological assessment

Background: In the surgical department, a breast lump is a frequent complaint. Correct diagnosis helps avoid unnecessary operations, and invasive treatments and to treat malignant lesions at the first sign of the disease. Aim: To compare the efficacy of clinical and radiological diagnostic modalities with histopathological examination to create a roadmap for the treatment of breast diseases. Methods: A prospective comprehensive study was conducted on 50 women presenting with breast complaints admitted to a tertiary care hospitals, over a period of 2 years. Results: All patients were >30 years of age with 52% in the 5 th decade. Lumps and pain were the major presenting complaints. 76% of the patients had benign while 24% of patients had malignant features on ultrasonography. On histopathology, 62% of patients had benign lesions and 38% had malignant lesions. Mammography was 86.67% sensitive, and 92% specific in comparison with histopathology with PPV of 86% and NPV of 92%. On comparison of ultrasonography with histopathology, sensitivity, specificity, PPV and NPV were 66.67%, 100%, 100%, and 83%. FNAC was 86.67% sensitive and 100% specific with a PPV of 100% and NPV of 92%. Conclusion: Breast cancer is a clinical diagnosis with a potential diagnostic error. Mammography and FNAC, offer higher PPV but lower sensitivity and specificity. When the diagnoses are combined for triple assessment, a conclusive diagnosis can be made. Clinical examination and FNAC alone may be sufficient in patients with distinct lumps to rule out cancer and is cost-effective by skipping mammography and ultrasound may be used instead.