Role of High Frequency Ultrasound in Evaluation of Palpable Breast Masses in Correlation with Conventional Mammography, Histopathology/Fine Needle Aspiration Cytology

Using high resolution Ultrasonography there are reliable signs to differentiate benign & malignant breast masses and select appropriate cases for mammography & HPE. Positive predictive value for biopsy can be increased by proper complete diagnostic work up in which sonomammography & conventional mammography is also included. Objective: The purpose of our study was to characterize the palpable solid breast mass and categorizing each mass as benign and malignant using high frequency ultrasonogram and to correlate the benign and malignant breast mass with mammographic & tissue diagnosis. Materials and Methods: This study was a prospective analysis which includes 50 female patients, of age ranging between 35–75 years with history of palpable breast mass. Data for the study was collected from the patients referred to Department of Radio diagnosis at Meenakshi Medical College and research institute Kanchipuram for the period of two years. A structured, pre-prepared case proforma (CP) was used to enter the clinical history, physical examination findings, investigations-sonomammography, conventional mammography and histopathology/FNAC findings. Later the conventional mammography findings and tissue diagnosis results were correlated with sonological findings by statistical analysis. Results: The US findings most predictive for a malignant tissue diagnosis were poorly defined/ spiculated or microlobulated margins, irregular shape, not oriented parallel to skin, taller than longer, > 3 lobulations and width-to–AP dimension ratio of 1.4 or less. The findings most predictive for a benign tissue diagnosis were oval or round shape, circumscribed margins, orientation parallel to skin, < 3 lobulations / microlobulations and width-to–AP dimension ratio greater than 1.4. Conclusion: Ultrasound features for differentiating benign from malignant solid masses have the potential to help to avoid radiation exposure & decrease the number of biopsies performed for benign solid masses.