Diagnostic Performance of Combined Mammogram and Ultrasound in Diagnosis of Breast Cancer*

Abstract

Diagnostic Performance of Combined Mammogram and Ultrasound in Diagnosis of Breast Cancer*

Sirirat                 Teavirat                              MD**

Virakiat              Hirunvivathanakul           MD***

Somnuk             Jedsadapatharakul          MD****

*This work was supported by the Vajira research Fund (annual research fund 1999)

**Department of Radiology, BMA Medical College and Vajira Hospital

*** Department of Surgery, BMA Medical College and Vajira Hospital

**** Department of Pathology, BMA Medical College and Vajira Hospital

Objective: To evaluate the accuracy of combined mammogram and ultrasound in diagnosis of breast cancer.

Study design: Diagnostic test.

Subjects: One hundred and forty-four patients who had breast mass of more than 1 cm in diameter detected from mammogram and ultrasound at BMA Medical College and Vajira Hospital from August 1999 to March 2002.

Methods: The mammograms and ultrasound of the patients who had breast mass of more than 1 cm in size were reviewed. All patients breast mass excised for pathological diagnosis. The results of mammographic combined with ultrasonographic findings were compared with pathological diagnosis.

Main outcome measures: The sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value, negative predictive value, post test likelihood if test negative, positive likelihood ratio and negative likelihood ratio of combined mammogram and ultrasound to evaluate accuracy in diagnosis of breast cancer.

Result: In this study, the prevalence of breast cancer in patients who had breast mass detected from mammogram and ultrasound was 29.8% (43 out of 144 patients) The sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value, negative predictive value of combined mammogram and ultrasound to evaluate accuracy in diagnosis of breast cancer were 97.7, 84.2, 88.2, 18.8, 2.3, 72.4 and 98.8% respectively. The post test likelihood if test negative, positive likelihood ratio and negative likelihood ratio were 0.01, 6.4 and 0.03 respectively.

Conclusion: The accuracy of combined mammogram and ultrasound in diagnosis of breast cancer was quite high. They were the useful studies and should be performed in all patients with suspected performed in all patients with suspected breast pathology.

Key words: mammogram, ultrasound, breast cancer

Vajira Med J 2002 ; 46 : 115 - 123