The importance of combining of ultrasound and mammography in breast cancer diagnosis.

Objective. The aim of this study was to analyse individual and combinedsensitivity and specificity of ultrasound and mammography inbreast cancer diagnosis and emphasize the importance of combiningbreast imaging modalities. Patients and methods. By means ofa cross-sectional study, ultrasound and mammographic examinationsof 148 women (mean age 51.6 ± 10.8 years) with breast symptomswere analysed. All women underwent surgery and all lesions were examinedby histopathology analysis which revealed the presence of 63breast cancers, and 85 benign lesions. In relation to age, the womenwere separated in to a group under 50 years and a group 50 years andolder. Ultrasound and mammographic findings were classified on theBI-RADS categorical scale of 1-5. Categories 1, 2 and 3 were considerednegative, while categories 4 and 5 were positive for cancer. Forstatistical data processing the McNemar chi-square test for pairedproportions was used. The differences on the level of p<0.05 were consideredstatistically significant. Results. In the group under 50 years,the ultrasound sensitivity was significantly higher than the mammographicsensitivity (p=0.045, c2=4), without a statistically significantdifference in specificity (p=0.24, c2=1.39). In the women over 50, asignificant difference between sensitivity of ultrasound and mammographywas not proved (p=0.68, c2=0.17), nor any difference in thespecificities (p=0.15, c2=2.08). In the group consisting of all patients,the sensitivity of ultrasound was statistically significantly higher incomparison with the sensitivity of mammography (p=0.04, c2=4.27)with higher specificity (p=0.04, c2=4). By combining the two methodsin all patients sensitivity of 96.8% was achieved, in patients up to 50sensitivity was 90.47% and in patients over 50, sensitivity was 100%.When the two methods were combined in all patients, a decrease inspecificity was noted. Conclusion. The combination of ultrasound andmammography in breast cancer diagnosis achieves high sensitivityand the number of undetected breast cancers is reduced to minimum.