الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 162 |  |  |
| | | from | 162 | | |
Abstract
The dense breast is considered an important risk factor in the development of cancer breast. Early detection of breast cancer is to reduce the morbidity and mortality rates. Mammogram is the cornerstone examination in malignancy of breast. Mammogram detection of malignancy is reduced in women with dense breast. Hand Held Ultrasound (HHUS) came as a necessary complimentary imaging modality to overcome mammogram underperformance of in dense glandular tissue. However, the limitations of traditional hand-held ultrasound (HHUS), which include operator dependency, variability and long acquisition times. ABUS was created to standardize breast ultrasound and decrease some of HHUS limitations. 3D volumetric images are of high benefit to patients with dense breast. Aim of study: The aim of this study is to highlight the diagnostic interplay of ABUS as a complementary scan for mammography and HHUS in detection and diagnosis of breast lesions. The study enrolled 50 female patients who have dense breast on mammogram and / or young female less than 30 years old with breast complain; regarding ACR 33 cases (66%) were in class C and 17 cases (34%) were in class D. Inclusion criteria: • Clinically diagnosed or provisional diagnosed patients with breast lesions. • Patients with dense breast classified as (C) or (D) according to ACR BIRADS breast density classification, by mammogram. • Young female less than 30 years old with breast complain. Exclusion criteria: • Females with fatty breast. • Females with breast implants. Results: The mean age and SD of participants was 37.04 ys ± 10.95, all of the cases were females and 13 (26%) of them with positive family history 37 (74%) with negative family history. 64% of the studied cases were found to have previous lactating history. The studied cases were clinically presented by (35 patient (70%) breast lump, 34% tenderness or 4%nipple discharge) Among 50 candidates to the study, according to ACR, (American college of radiology) 66% were class C and 34% were class D The studied cases underwent ABUS and HHUS examinations and they were assessed according to examination time, we found that ABUS study had shorter examination time (mean +/- SD: 4.14 min +/- 0.88) than HHUS study (mean +/- SD: 9.42min+/-1.84) Although the ABUS couldn’t assess lesion vascularity, the lesions vascularity was assessed by HHUS. We detected lesion vascularity in 12% of cases. we found that the distribution of the cases according to axillary examination by HHUS; 88% of cases with non-significant lymphadenopathy, 10% of cases with suspicious lymphadenopathy and 2% of cases with no enlarged axillary lymph nodes Distribution of the studied cases according to BIRADS: by ABUS (32%) of patients with BIRADS (II), 20% of patients with BIRADS (III), 48% of patients with BIRADS (IV) and by Mammogram and HHUS 34%0 of patients with BIRADS (II), 20% of patients for BIRADS (III), 46% of patients for BIRADS (IV) Regarding final diagnosis 29 (58%) of cases were benign, 3 (6%) probably benign and 18 (36%) malignant as described. Regarding pathological finding, among 29 cases of our studied population 11 cases (37.9%) were benign,18cases (62%) were malignant. There was no statistically significant difference found between ABUS and Mamo &HHUS regarding BIRADS results. As p value between ABUS and Mamo & HHUS for BIRADS II, III, IV were (0.832, 1.000 and 0.841), The kappa agreement between BIRADS results by Mamo& HHUS and ABUS was found 0.905 which is considered very good agreement. We found the accuracy of ABUS to detect the lesion was 78%, with sensitivity of 94.4%, specificity of 70%, PPV was 70.8% and NPV100%. For Mammo & HHUS; the accuracy was 80%, with sensitivity of 94.4%, specificity of 73.3%, PPV was 73.9% and NPV 100%.