A comparative study of mri and triple assessment in evaluation of palpable breast masses

Introduction: A lump in the breast is of great concern to the patients and is also a challenge to the diagnostic judgement of the surgeon. Early diagnosis of breast cancer has increasingly resulted in a more conservative surgical approach to the disease. Methods: The present, comparative study was conducted in the Postgraduate Departement of General Surgery and Department of Radiodiagnosis and Imaging, Government Medical College Srinagar,for a period of obout two and a half years. A total of 60 patients underwent clinical examination by surgeon, FNAC by pathologist. Mammography/ultrasonography was done and evaluated by radiologist blinded to FNAC/Clinical examination reports, MRI breast was arranged and evaluated by radiologist blinded to result of triple test. Results: Most common age group affected was 50 to 70 years with a mean + SD of 50.9±14.47. Most common location of breast lesions in patients was upper outer quadrant 31 (51.7%) and least common location was lower inner quadrant 4 (6.6%). Left sided lesions 31(51.67%) were more than right sided lesions 28 (46.67%) with only 1 (1.66%) bilateral lesion. Benign lesions were present in 28 (46.33%) patients and malignant lesions were present in 32 (53.33%) patients. Pain was the most common symptom present in the patients 25 (41.7%) followed by nipple discharge 7 (11.7%) and then weight loss, 6(10%) patients. Skin changes were present in 20% patients,4 (6.67%) had nipple retraction, enlarged axillary lymph nodes were seen in 21 (35%) patients. the accuracy of triple test in the evaluation of breast lesions with 96.9% sensitivity and 67.9% specificity and positive and negative predictive value of 77.5% and 95.0% respectively. the accuracy of MRI in the evaluation of breast lesions with 96.9% sensitivity and 89.3% specificity and positive and negative predictive value of 91.2% and 96.2% respectively. Conclusion: Magnetic Resonance Imaging (MRI) breast is equally sensitive to triple assessment in the evaluation of breast masses. It is more specific than triple test in the evaluation of palpable breast masses. Positive predictive value and negative predictive value of MRI is more than triple assessment. MRI is able to detect occult lesions of opposite breast.