Perfomance measures of diagnostic ultrasound of the breast in Lagos University Teaching Hospital (LUTH), Nigeria

Abstract

The performance of Ultrasound (US) among patients presenting with signs and symptoms of malignancy was studied in comparison to surgical pathological findings. 310 patients who presented to the surgical out-patients of the Lagos University Teaching Hospital with signs and symptoms of breast cancer, between 2002 and 2003 were sonographically evaluated. US was performed with Sonoline SL-I (Siemens AG Germany) using a 7.5 MHz linear array transducers. The sonographic appearances were prospectively classified using the Breast Imaging Reporting and Data System (BI-RADS) assessment categorization. Histological confirmation following surgical excision was correlated with US. The overall sensitivity of diagnostic US in the study was 83.9% (95% CI 79.8-88%), while PPV, specificity, NPV and accuracy were 96.3% (95% CI 94.2-98.4%), 99.2 (95% CI 98.2-100%), 96.1% (95% CI 93.9-98.3%) and 96.1% (95% CI 93.9-98.3%) respectively. Univariate analysis showed that sensitivity and specificity generally declined as breast fattiness increased. Diagnostic US is useful in characterizing breast lesions. This study analyzed the performance of US and shows that the resultant specificity is high; however it may have to be used in conjunction with needle biopsy to achieve improved sensitivity and avoid unnecessary benign surgical biopsies.

Nigerian Medical Practitioner Vol. 49(1&2) 2006: 28-33