Diagnostic Accuracy of Ultrasound and Mammography to Detect Breast Cancer in Lampang Hospital

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กาญจนาพร มหัทธนพรรค


Background: There were many women suspected breast cancer awaiting mammography in Lampang Hospital whereas ultrasound is sooner and easier. It may be possible to use ultrasound as initial imaging examination for breast cancer diagnosis.
Objective: To determine diagnostic performances of mammography and ultrasound to detect breast cancer, including their affected factors.
Material and method: Retrospective study was conducted on women underwent both mammography and ultrasound in Lampang Hospital between May 2013 and April 2014. BI-RADS categorization and pathological reports were recorded. Diagnostic performances were analyzed and compared between tests, age group, indication and breast density.
Results: There were 1,414 women enrolled in the study (mean age 52 years, range 27- 85). Seventy-five percent was asymptomatic (1,060 cases). Imaging results were categorized as BI-RADS 1 in 239 (16.9%), BI-RADS 2 in 694 (49.1%), BI-RADS 3 in 319 (22.6%), BI-RADS 4 in 100 (7.1%), BI-RADS 5 in 57 (4.0%) and BI-RADS 6 in 5 cases (0.3%). Histopathological analyses were obtained in 148 cases, among these 84 were found malignant. Mammography yielded
sensitivity, specificity, accuracy, positive and negative predictive value for 55.2%, 92.9%, 96.7%, 96.5%, 63.9% and 99.5%. Those of ultrasound were 58.0%, 97.6%, 96.2%, 96.3%, 62.1% and 99.8% whereas combined both tests yielded 59.4%, 100%, 94.1%, 94.5%, 51.9% and 100% respectively. High breast density reduced mammographic sensitivity but had no effect to ultrasound. Ultrasound had higher sensitivity than mammography in women aged <50 years
or presented with palpable mass.
Conclusion: Ultrasound is highly accurate and may be appropriate for initial investigation in women presented with breast mass, especially in <50 years age group or high breast density. However, combined ultrasound and mammography are recommended to prevent false negative result of single test.


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มหัทธนพรรค ก. (2015). Diagnostic Accuracy of Ultrasound and Mammography to Detect Breast Cancer in Lampang Hospital. Lampang Medical Journal, 36(1), 1–13. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/186415
Original Article


1. Key TJ, Verkasalo PK, Banks E. Epidemiology of breast cancer. Lancet Oncol 2001;2(3):133-40.
2. Berg WA, Blume JD, Cormack JB, Mendelson BB, Lehrer D, Bohm-Velez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 2008;299(18):2151-63.
3. Mujagic S, Burina M, Mustedanagic-Mujanovic J, Sarkanovic G. The importance of combining of ultrasound and mammography in breast cancer diagnosis. Acta Med Acad 2011;40(1):27-33.
4. Zonderland HM, Coerkamp EG, Hermans J, Van de Vijver MJ, Van Voorthuisen AE. Diagnosis of breast cancer: contribution of US as an adjunct to mammography. Radiology 1999;213:413-22.
5. Houssami N, Irwig L, Simpson JM, Mckessar M, Blome S, Noakes J. Sydney breast imaging accuracy study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms. Am J Roentgenol 2003;180:935-40.
6. Ikeda DM. Breast imaging. Philadephia:Elsevier Mosby;2004.
7. American College of Radiology. ACR BI-RADS-Mammography. In: ACR Breast imaging reporting and data system atlas. 4th ed. Reston: American College of Radiology;2003.
8. Fatima N, Zaman MU, Uddin Q, Ahsan Z. Accuracy of mammography and ultrasound for detecting breast cancer at a breast care clinic in Karachi, Pakistan. J Biomed Graph Comput 2011;1(1):44-50.
9. Kaiser JS, Helvie MA, Blacklaw RL, Roubidoux MA. Palpable breast thickening: role of mammography and US in cancer detection. Radiology 2002;223:839-44.
10. Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them : An analysis of 27,825 patient evaluations. Radiology 2002;225:165-75.
11. Kaplan SS. Clinical utility of bilateral whole-breast US in the evaluation of women with dense breast tissue. Radiology 2001;221:641-9.
12. Berg WA. Diagnostic imaging breast. Canada: Amirsys;2006.