Evaluation of the accuracy of mammography, ultrasound and magnetic resonance imaging in suspect breast lesions.

OBJECTIVES: In breast cancer diagnosis, mammography (MMG), ultrasonography (USG) and magnetic resonance imaging (MRI) are the imaging methods most used. There is a scarcity of comparative studies that evaluate the accuracy of these methods in the diagnosis of breast cancer. METHODS: A cross-sectional study was carried out through the review of electronic medical records of 32 female patients who underwent breast imaging examinations at a imaging diagnostic center in Teresina, State of Piauí, Brazil. Patients who had these three imaging methods at the time of the evaluation of the same nodule were included. The nodule must have been classified as suspect by the BI-RADS® system in at least one of the methods. Data from each method were compared with the histopathological examination. Statistical analysis used the calculation of proportions in Excel 2010. RESULTS: MMG showed 56.2%, 87.5%, 81.8%, 66.7% and 71.8% of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy, respectively. USG had 75%, 18.8%, 48%, 42.8% and 46.9% of sensitivity, specificity, PPV, NPV and accuracy, respectively. In turn, MRI had 100%, 50%, 66.7%, 100% and 75% of sensitivity, specificity, PPV, NPV and accuracy, respectively. CONCLUSION: Thus, MRI and MMG were more accurate in evaluating suspicious breast lumps. MRI had a low specificity, mainly to high breast density, while MMG had also sensitivity limited due to high breast density and USG has been proven to be useful in these patients.

Evaluation of the accuracy of mammography, ultrasound and magnetic resonance imaging in suspect breast lesions

OBJECTIVES: In breast cancer diagnosis, mammography (MMG), ultrasonography (USG) and magnetic resonance imaging (MRI) are the imaging methods most used. There is a scarcity of comparative studies that evaluate the accuracy of these methods in the diagnosis of breast cancer. METHODS: A cross-sectional study was carried out through the review of electronic medical records of 32 female patients who underwent breast imaging examinations at a imaging diagnostic center in Teresina, State of Piauí, Brazil. Patients who had these three imaging methods at the time of the evaluation of the same nodule were included. The nodule must have been classified as suspect by the BI-RADS® system in at least one of the methods. Data from each method were compared with the histopathological examination. Statistical analysis used the calculation of proportions in Excel 2010. RESULTS: MMG showed 56.2%, 87.5%, 81.8%, 66.7% and 71.8% of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy, respectively. USG had 75%, 18.8%, 48%, 42.8% and 46.9% of sensitivity, specificity, PPV, NPV and accuracy, respectively. In turn, MRI had 100%, 50%, 66.7%, 100% and 75% of sensitivity, specificity, PPV, NPV and accuracy, respectively. CONCLUSION: Thus, MRI and MMG were more accurate in evaluating suspicious breast lumps. MRI had a low specificity, mainly to high breast density, while MMG had also sensitivity limited due to high breast density and USG has been proven to be useful in these patients.

Use of the Patent Blue and Air in the Preoperative Marking of Impalpable Breast Lesions.

OBJECTIVE: The goal of this study is to analyze the applicability of the patent blue dye and air in the preoperative marking of impalpable mammary lesions with indication of surgical resection. MATERIALS AND METHODS: A prospective cohort study was performed. We selected 49 patients with detection of impalpable lesions on a breast mammography or breast ultrasonography. The patients received the dye injection as close to their surgery time as possible. The criteria analyzed included: 1) complete marking and identification of the lesion; 2) complete removal of the lesion; 3) in cases of malignant lesions, presence of free margins for successful surgery; 4) occurrence of allergic events; 5) necessity of reoperation; and 6) difficulty in locating lesions. RESULTS: All lesions were marked, and they were successfully excised. In cases of malignancy, free margins were obtained in 100% of the cases. There were no allergic events or reoperations. Only 8.9% of the lesions were difficult to locate. CONCLUSION: The marking with patent blue and air is an effective alternative for the labeling of impalpable breast lesions, and it has satisfactory surgical oncology results. All lesions were resected, 91.1% of them were performed with no difficulties, and free margins were obtained in 100% of cases of malignancy.