Online ISSN: 2515-8260

Keywords : BIRADS

Cytomorphological and histopathological correlation with imaging findings in breast lumps: A retrospective study from a tertiary cancer centre

Sasmita Panda, Mamita Nayak, Sagarika Samantaray

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2097-2103

Background: Breast cancer is the most common cancer in the Indian women accounting for 27.7% of all the female cancers in india. Breast lumps are common which require appropriate workup consisting of clinical examination, imaging and fine needle aspiration cytology. Imaging and cytopathology are crucial in categorising these lesions into benign and malignant. There is a requisite to determine the concordance of these these findings and evaluate the diagnostic efficacy. The objectives is to find  the correlation  of cytopathological diagnosis with imaging findings for provisional diagnosis of breast lumps and to evaluate the utilisation  of fine needle aspiration as a cheap, safe method for preoperative assessment of breast lumps.
Materials and methods: All Fine needle aspiration (FNAC) of breast lumps were included in the study from Jan 2019 to Dec 2020.Their imaging findings were retrieved from the records. Only those with imaging findings were included in this study.
Results: 275 patients came for FNAC for breast lesions, out of these breast Ultrasound/ Mammography findings were available in 255 cases which were included in our study. Cytohistological correlation was obtained in 243 cases. In this sudy the sensitivity-90.3%, specificity=87.41%,positive predictive value (PPV) was 83.18%,negative predictive value (NPV) was 92.9%, with diagnostic accuracy of 88.6% for imaging findings in diagnosis of breast lesions(in comparison with histopathology considered to be gold standard for diagnosis). The Sensitivity was 99.02%, specificity was 99.29%, PPV was 99.02%, NPV was 99.29%, and the diagnostic accuracy was 95.29%for FNAC in diagnosis of breast diseases (considering histopathology as gold standard).
Conclusion: Cytological evaluation is a standardised ideal cheap ancillary method in evaluating the breast lumps which many a times masquerades breast cancers.

The profusion of breast lesions in breast biopsies showed imaging and pathological discordance

1Amod Kumar, 2Aashish Gupta, 3Monica, 4Payal Kumari, .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3286-3293

Introduction: For nonpalpable breast lesions, imaging-guided breast tissue biopsy has become a viable alternative to open surgical biopsy. It can be difficult to talk about abnormal results of the connection between imaging and pathology findings because they can help with decision-making about additional treatment options by arriving at a full diagnosis.
Materials and Methods: This was a retrospective study. A specialist radiologist collected and classified radiological data from 500 patients' imaging-guided breast biopsies over a 6-year period using the BIRADS format. The discordance between histopathology reports was investigated.
Results: A total of 500 cases were reviewed. Approximately 4.6% (23) of cases fell into BIRADS 2 category, 33.6% (168) of cases fell into the BIRADS 3 category, 24.4% (122) into the BIRADS 4, 36.6% (183) into BIRADS 5 categories and 0.8% (4) into BIRADS 6 categories. Approximately 49.2% (n = 246) cases were benign, 3.4% (17) belonged to the high‑risk category, and 47.4% (237) were malignant. The number of discordant cases was 12 (2.4%), mostly due to technical factors. The sensitivity of biopsies to detect malignancy was 85%, specificity was 96%, and accuracy of biopsy in diagnosing cancer was 90%.
Discussion: The most sensitive way for detecting early breast cancer is the "triple assessment." Because of the high occurrence of carcinoma in these lesions, an effective communication line between a physician, radiologist, and pathologist is required for surgical excision in discordance.
Conclusion: In discordant cases, the ultimate choice is based on two concordant findings out of the three parameters, either due to abnormal imaging results or abnormal pathology findings. A multidisciplinary breast conference is held, with the pathologist taking an active role.


1Dr.Preethi.V 2Dr.Vijay.S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4802-4808

Aims and objectives: To recognize, describe the radiological manifestations and correlate pathologically the breast disorders related to lactation. To ascertain the value of the different radiological modalities in such disorders
Materials and Methods: This is an observational prospective study of 50 lactating women who presented with breast complaints. They were subjected to X-ray mammography, sonomammography and MR mammography with contrast if needed. All reports were histologically verified and correlated
Results: Of the 50 women evaluated, the following diseases were diagnosed: Puerperal mastitis (n= 18, 36%); Breast abscess (n=6, 12%); Granulomatous mastitits (n=4, 8%); Galactocele (n=10, 20%); Lactating adenoma (n=2, 4%); Fibroadenoma (n=8, 16%); Pregnancy associated breast cancer (n=2, 4%). Of the 50 women evaluated, sonomammography upstaged the Xray mammography BIRADS category for 8 women which also corresponded with the HPE findings, X-ray mammography did not upstage the sonomammography BIRADS category for any woman, X-ray mammography and sonomammography showed similar findings in 42 women and MRI was used in indecisive cases, in 9 women, where the findings correctly predicted the HPE outcome.
Conclusion: Familiarity with the imaging spectrum of breast disorders during lactation is essential in today’s scenario. It would be a better practice to always perform USG evaluation in lactating women referred to X-ray mammography for breast complaints and to use MR mammography for indecisive cases.