Ultrasound Findings of MammographicallyDense Breasts in a Sample of Iraqi Female PatientsDOI:https

Abstract

Background: Breast problems including breast cancer have been increasing in Iraq during the recent years. Yet, early detection and screening programs using mammography mainly with complementary ultrasound had dramatically decreased the mortality rates from this emerging disease. Objective: To assess the dense breast detected by mammography for the presence of any hidden suspicious lesion by using ultrasound.  Patients and methods:  this is a cross - sectional study on 53 female patients who came for breast cancer screening or attended the Breast Clinic in the Oncology Teaching Hospital of the Medical City Complex in Baghdad –Iraq. The study was conducted from January to October 2018. Two -view mammography was done for each breast, and those with dense breasts underwent further ultrasound assessment done by a board- certified radiologist. Results: The mean age for the 53 patients included in the study was 48 years. Mammographic findings showed that heterogeneous fibroglandular tissue density was present in (89%) of the study population. Suspicious or clearly defined mass(es) by mammograph were seen in 16 (30%) of the patients, while no mass was identified in (22%). Ultrasound findings we re as follows: Suspicious mass in (75%) of the cases and benign lesions such as simple cysts or fibroadenoma in (9%). The results showed that ultrasound has upgraded 12 cases that were diagnosed as BI -RADS I/II to BI-RADS IV/V and this represented (23%) of the cases. On the other hand, the mammogram and the ultrasound were in concordance for BI  RADS IV/V in 28 cases (54%). The positive predictive value of the ultrasound and the mammogram for BI - RADS IV and V breast lesions is 72% for BI - RADS IV and 95% for BI - RADS V for ultrasound and that  of mammograph is 83% for BI - RADS IV 80% for BI- RADS V, while the negative predictive value of  mammograph is 55% for BI - RADS I/II 25% for BI - RADS III. Conclusion: Dense breast is still an important problematic issue in mammographic screening as it may obscure small lesions, for which, ultrasound is proved to be a complementary and essential targeting tool in the assessment process.