Diagnostic accuracy of ultrasound in detection of pregnancy associated breast cancer

Abstract

Introduction: Some unique physiological changes occur in breast volume and water content during pregnancy which makes the radiological evaluation of the breast difficult.  As a result, diagnosis of Pregnancy Associated Breast Cancer.  is often delayed. Objective: To find out the diagnostic accuracy of ultrasonography in detection of pregnancy associated breast cancer taking histopathology as gold standard. Methodology: Present Cross-sectional study was carried out at INMOL Hospital, Lahore. Ultrasound of 200 women was performed. The patient was laid supine and then turned slightly in oblique position to scan the breast with high frequency linear probe (7.5-10 MHz). The contra-lateral breast and both axillae were also scanned in the same way. Findings were categorized on the basis of Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Subsequently the breast tissue was sent to histopathology laboratory for tissue diagnosis. The pathologist was blinded of the results of ultrasonography. Results: Mean age was 34 ± 11.36 years. Twenty-eight percent patients were primi-para while 72% patients were multi-para. Diagnostic accuracy of ultrasonography taking histopathology as gold standard was analyzed and ultrasonography had sensitivity 84.78%, specificity 98.05%, positive predictive value 92.85%, negative predictive value 95.56% and diagnostic accuracy was 95%. Invasive ductal carcinoma was most commonly observed (P<0.001) malignant histopathology. On the other hand, significantly high (P = 0.033) number of benign lesions were Fibroadenomas. Conclusion: The high sensitivity and specificity along with easy availability, and non-invasive nature makes ultrasonography a very useful technique for the diagnosis of Pregnancy Associated Breast Cancer.