Universal Journal of Public Health Vol. 11(4), pp. 415 - 421
DOI: 10.13189/ujph.2023.110405
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Diagnostic Accuracy of Ultrasound Findings in Suspected Breast Cancer Patients: A Tertiary Hospital's Experience

Adrian Hoti ^1,2, Alketa Ymeri ², Edmond Gashi ², Fatjona Kraja ², Aldo Shpuza ^3,*, Eda Hoti ⁴, Xhesika Xhetani ¹, Carol Jabari ⁵, Enver Roshi ^3
1 Department of Imagery and Clinical Semiotics, University of Medicine, Albania
² Oncology Service, University Hospital of Tirana, Albania
³ Department of Public Health, University of Medicine, Albania
⁴ Faculty of Medicine, University of Medicine, Albania
⁵ Mediterranean Task Force for Cancer Control, Albania

ABSTRACT

Aim: This study was aimed at assessing the diagnostic accuracy of ultrasound (US) in patients suspected of having breast cancer and confronting diagnosis by US imaging with histopathological diagnosis in patients of different ages. Methods: We performed a prospective case series of 280 patients suspected of having breast cancer, and referred to the tertiary University Hospital of Tirana ("Mother Teresa") for further evaluation, during January 2021-December 2021. These patients were diagnosed with US imaging, using the Breast Imaging Reporting and Data System (BI-RADS) as a tool for evaluating cancer risk. Subsequently, histopathology was carried out (used as a gold standard for diagnosis). The accuracy of US was evaluated by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV); the performance of US was evaluated by Receiver Operator Curve (ROC), and different associations between variables were assessed by conducting a chi-square test and binary logistic regression. Results: With increased age, BI-RADS 2 or 3 cases decreased [48.1% (15-40 years) vs 35.6% (40-49 years) vs 21.4% (50-59 years) vs 9.2% (60-69 years) vs 6.3% (over 70 years)], (p<0.001), while BI-RADS 4 or 5 increased (51.9% vs 64.5% vs 78.6% vs 80.8% vs 93.8%), (p<0.001), respectively in the above-mentioned age groups. Similarly, with increased age, benign diagnosed cases in histopathology decreased (72.2% vs 57.6% vs 44.3% vs 43.1% vs 21.9%), (p<0.001). There was an increase in malignancies according to histopathology amongst older patients, (27.8% vs 42.4% vs 55.7% vs 56.9% vs 78.1%, (p<0.001), respectively. In terms of US cancer diagnosis accuracy, our findings showed high sensitivity and NPV (97.9%, 95.7%), not very high specificity (48.2%), and satisfactory PPV and accuracy (65.7%, 73.2%). Meanwhile, the ROC curve showed an Area under the Curve value of 0.81, p<0.01. Conclusion: The US, using BI-RADS, is a good tool for detecting malignant breast cancer in patients of all ages. The accuracy of US is satisfactory for tertiary diagnostic service, nonetheless, all components must be considered to ensure that the US diagnosis always coincides with the histopathological diagnosis of malignant breast cancer.

KEYWORDS
Ultrasound, Breast Cancer, BI-RADS, Albania

Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] Adrian Hoti , Alketa Ymeri , Edmond Gashi , Fatjona Kraja , Aldo Shpuza , Eda Hoti , Xhesika Xhetani , Carol Jabari , Enver Roshi , "Diagnostic Accuracy of Ultrasound Findings in Suspected Breast Cancer Patients: A Tertiary Hospital's Experience," Universal Journal of Public Health, Vol. 11, No. 4, pp. 415 - 421, 2023. DOI: 10.13189/ujph.2023.110405.

(b). APA Format:
Adrian Hoti , Alketa Ymeri , Edmond Gashi , Fatjona Kraja , Aldo Shpuza , Eda Hoti , Xhesika Xhetani , Carol Jabari , Enver Roshi (2023). Diagnostic Accuracy of Ultrasound Findings in Suspected Breast Cancer Patients: A Tertiary Hospital's Experience. Universal Journal of Public Health, 11(4), 415 - 421. DOI: 10.13189/ujph.2023.110405.