Mammographic and ultrasonographic findings in clinical breast pain
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Abstract
Mammographic and ultrasonographic findings in clinical breast pain
Abstract
Background: It was widely accepted that the gold standard for diagnosis of breast cancer is mammogram with additional breast ultrasound. This study focused at the proper investigation that has cost effectiveness, less radiation risk and high detection rate in case of clinical breast pain without abnormal clinical breast examination, because clinical breast pain is not a common symptom of breast cancer1.
Objective: To assess findings of mammogram and ultrasound in case of breast pain alone, and to assess detection rate of breast lesion by mammogram and by ultrasound.
Design: Diagnostic descriptive research. Patients: one hundred and forty female patients age 35 -79 years old presented with breast pain alone without other findings of clinical breast examination undergone mammogram and ultrasound examination in Chiangrai Prachanukroh hospital between October 2015 and August 2017.
Measures and statistics analysis: Assessment of percentage of detection in both ultrasound and mammogram, ultrasound alone, mammogram alone, and either ultrasound or mammogram. Comparison of percentage of lesion detection using Fisher exact test among these variables was done.
Main outcomes: Lesions detection in 52 cases (37.2%), no lesion detection in 88 cases (62.8 %). Most of findings are cysts (30% of patients) and solid (3.7% of patients). Forty cases (28.6% of patients) were detected by ultrasound alone. One case (0.007% of patients) detected by mammogram alone (asymmetrical breast density demonstrated by mammogram but no detected lesion in ultrasound). Eleven cases (7.9% of patients) were detected by both mammogram and ultrasound. There was no significant difference between positive detection rate by ultrasound alone and by either ultrasound or mammogram, but significant different between mammogram and either one of these investigations.
Conclusion: Consideration about detection rate, cost benefit and radiation risk from mammogram, in the initial investigation in case with isolated breast pain should be started with breast ultrasound rather than mammogram. In case of suspicious malignancy, further investigation such as mammogram or biopsy is of value.
Key word: breast pain, mammogram, ultrasound
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References
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