DIAGNOSTIC ACCURACY OF PALPABLE BREAST LUMP AND NIPPLE RETRACTION ON SONO ELASTOGRAPHY TAKING HISTOPATHOLOGY AS A GOLD STANDARD

Abstract

Background: Early and accurate differentiation between benign and malignant breast lesions is essential for effective management. Palpable breast lumps and nipple retraction are common clinical findings, but they are not always sufficient to determine lesion nature. Sono elastography, combined with conventional ultrasound and Doppler evaluation, may improve diagnostic accuracy.

Objective: To evaluate Diagnostic Accuracy of Palpable Breast Lump and Nipple Retraction on Sono elastography taking histopathology as a gold standard.

Methods: This prospective cross-sectional study included 173 patients presenting with palpable breast lumps and/or nipple retraction. All patients underwent B-mode ultrasonography, color Doppler, and Sono elastography. Variables assessed included lesion margins, vascularity, posterior acoustic shadowing, elastography pattern, and nipple retraction. Histopathology served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated. Associations between variables and malignancy were analyzed using the Chi-square test.

Results: Of 173 lesions, 100 (57.8%) were benign and 73 (42.2%) malignant. Malignant lesions were significantly associated with irregular margins (83.6%), vascularity (79.5%), posterior acoustic shadowing (68.5%), hard elastography pattern (68.5%), and nipple retraction (41.1%) (p < 0.001). Sono elastography demonstrated a sensitivity of 87%, specificity of 90%, PPV of 83%, NPV of 92%, and overall accuracy of 88%.

Conclusion: Sono elastography, in combination with conventional ultrasound and Doppler evaluation, improves the diagnostic accuracy of differentiating benign and malignant breast lesions but Histopathology remains the gold standard for definitive diagnosis.