scholarly journals ROLE OF ULTRASOUND STRAIN ELASTOGRAPHY FOR THE EVALUATION OF BREAST LESIONS

2020 ◽  
pp. 4-6
Author(s):  
Deoyani S Sarjare ◽  
Arti Anand ◽  
Soumya Agrawal ◽  
Shanas K. P. ◽  
Sandhya Yeshwante

Introduction: Ultrasound (US) elastography is an emerging technique that can be used during breast US examination. Guidelines recommend mammographic screening and US for diagnosis of breast cancer. The specificity of these techniques is not high enough to prevent unnecessary biopsies. Hence there is need for a more specific technique to overcome this problem. This study aimed to evaluate the value of strain elastography (SE) for breast lesions. Materials and Methods: In this cross sectional observational study over 18 months, 60 women with palpable breast lumps were evaluated with conventional US and SE. Results obtained were correlated with histopathological findings for statistical analysis. Result: A statistically significant correlation was found between SE and histopathological outcome with a p value of 0.03(<0.05). The positive predictive value (PPV) was 76.92% and the negative predictive value (NPV) was 76.47% with Chi square= 8.4. Conclusion: Ultrasound with SE can substantially improve the possibility of differentiating benign from malignant breast lesions thereby limiting recourse to biopsy and considerably reducing the number of benign breast biopsy diagnoses.

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided


2018 ◽  
Vol 5 (2) ◽  
pp. 395
Author(s):  
Elayaraja Kandasamy ◽  
Senthil Kumar Andy

Background: Gastro Esophageal Reflux Disease (GERD) is the most common esophageal disorder in children of all ages. GER becomes pathological when reflux increase in frequency and intensity, associated with esophageal and respiratory symptoms. Thus, the study was determined to assess the prevalence of GERD in regurgitant children of age 6 to 24 months with evaluation of IGERQ score (Infant Gastro Esophageal Reflux Questionnaire).Methods: A descriptive study was conducted in Gastroenterology Department, Institute of child Health and Hospital for Children, Egmore, Chennai from September 2007 to September 2009. 123 regurgitant children of age 6-24 months were enrolled. Clinical examination and validated questionnaire with total score of 25 was used. Data analysis was aided by EPI info programme. Chi square with P value <0.05 was considered statistically significant. IGERQ score was evaluated by calculating sensitivity, specificity, positive predictive valve and negative predictive valve.Results: The prevalence of GERD in regurgitant infant and children is 30.8%. Refusal of feeds and poor weight in regurgitant children significantly correlated with GERD. sensitivity was 84%, specificity was 96%, positive predictive value was 91%, negative predictive value was 93%Conclusions: Clinical diagnosis of GERD is sufficient in most instances and a questionnaire may aid in diagnosis the disease. IGERQ score is easily adaptable. IGERQ score >5 has high specificity positive and negative predictive value but reproducibility in our population need further evaluation. 


Ultrasound ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 164-173
Author(s):  
Dimpi Sinha ◽  
Sukrity Sharma ◽  
Nischal G Kundaragi ◽  
Sudhir Kumar Kale

Background Elastography is a new promising ultrasonographic technique which is used to differentiate benign and malignant breast lesions based on the stiffness of the lesion. Purpose To determine the role of strain elastography in characterisation of breast lesions and to compare the diagnostic performances of strain elastography and conventional ultrasound (US). Methods In total, 113 breast lesions in 100 women were prospectively evaluated by US and strain elastography followed by the histopathological examination. Elastography score based on the Tsukuba colour scale and strain ratio were determined for each lesion. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated for each modality and the diagnostic performances were compared. The best cut-off point was calculated for each of the elastography parameters using the receiver operator curve analysis. Results Out of the 113 lesions, 40 were malignant (35.4%) and 73 were benign (64.6%). The area under the curve for elastography score showed significant difference with that of US: 0.98 versus 0.90 (Difference = 0.08, p =0.02). The elastography parameters were more specific as compared to US (ES-95 and SR-93% vs. 63%, p < 0.05) with a high negative predictive value. The combined use of elastography and US gave better results with 95% sensitivity, 94% specificity, 94% accuracy and negative predictive value reaching 97%. Conclusion Strain elastography is a useful adjunct to conventional ultrasonography. The combined use of strain elastography and ultrasound improves the characterisation of breast lesions and helps in down-staging of assigned BI-RADS category, thereby avoiding unnecessary biopsies. ES is the most useful elastography parameter to differentiate between benign and malignant breast lesions.


2019 ◽  
Vol 11 (02) ◽  
pp. 187
Author(s):  
Herdini Widyaning Pertiwi ◽  
Shafira Kaesa Siska Hapasari

ABSTRAK                           Latar belakang : Angka kematian akibat kanker payudara meningkat setiap tahun. SADARI merupakan upaya pencegahan yang efektif untuk mendeteksi dini adanya benjolan pada payudara. SADARI sebaiknya dilakukan sejak usia 20 tahun setiap bulan. Mahasiswi Kebidanan sudah mendapatkan pendidikan berupa materi perkuliahan tentang SADARI pada semester 4 sehingga berpeluang besar melakukan SADARI secara rutin. Tujuan penelitian ini adalah menganalisis hubungan pengetahuan dengan perilaku pemeriksaan payudara sendiri (SADARI) pada mahasiswi kebidanan di Stikes Estu Utomo. Penelitian ini menggunakan jenis penelitian observasional dengan pendekatan cross sectional. Populasi dalam penelitian adalah mahasiswi program studi sarjana kebidanan semester 7 Stikes Estu Utomo angkatan 2019 dengan jumlah sampel 49 orang. Teknik pengambilan sampel menggunakan  total sampling. Analisis data menggunakan uji Chi Square. Hasil penelitian menunjukkan Responden dengan pengetahuan cukup mayoritas jarang melakukan SADARI yaitu 80% dan responden dengan pengetahuan baik juga jarang melakukan SADARI yaitu 94,3%. Hasil analisa bahwa tidak ada hubungan antara pengetahuan dengan perilaku pemeriksaan payudara sendiri (SADARI) pada Mahasiswi Stikes Estu Utomo (p-value=0,250).Kata Kunci : Pengetahuan, SADARI RELATIONSHIP BETWEEN KNOWLEDGE WITH BEHAVIOR OF EXAMINATION OF SELF BREAST (BSE) IN MIDWIFES STUDENTS IN HIGH SCHOOL OF HEALTH SCIENCE UTOMO ESTU  ABSTRACTBackground: Mortality from breast cancer increases every year. Breast self-examination behavior (BSE) is an effective preventive measure to detect breast lumps early. BSE should be done from the age of 20 years every month. Midwifery students have received education in the form of lecture material about BSE in semester 4 so there is a great opportunity to do BSE routinely. The purpose of this study was to analyze the relationship of knowledge with SADARI in midwifery students at Estu Utomo Stikes. This research uses observational research with cross sectional approach. The population in this study was the 7th semester midwifery study program at the Estu Utomo Stikes class of 2019 with a sample of 49 people. The sampling technique uses total sampling. Data analysis using Chi Square test. The results showed that Respondents with sufficient knowledge of the majority rarely do SADARI that is 80% and respondents with good knowledge also rarely do SADARI which is 94.3%. The analysis there was no relationship between knowledge with SADARI) on Stikes Estu Utomo students (p-value = 0,250).Keywords: Knowledge, SADARI


2019 ◽  
Vol 6 (1) ◽  
pp. 12
Author(s):  
Shuaeb Bhat ◽  
Tania R. P. ◽  
Saleem Hussain ◽  
Bushra Sahaf ◽  
Irfan Ansari

Background: Breast cancer is the most frequent cancer in India. During the last few years, several investigators have focused on tumor angiogenesis as a critical step in cancer development and progression. Among these, vascular endothelial growth factor (VEGF) is emerging as a prognostic marker in patients with several type of cancer including breast cancer. The aim of the study was to analyse the expression of VEGF in human breast cancer as compared to normal breast tissue and benign breast lesions by immunohistochemistry. Also, to assess the usefulness of VEGF as a predictor of aggressiveness of breast lesions.Methods: Formalin fixed paraffin embedded sections of 10 cases of normal breast tissue, 20 cases of benign breast lesions and 20 cases of malignant breast lesions were taken up for the study and subjected to immunohistochemistry using VEGF.Results: The intensity of VEGF immunostaining in normal breast, benign and malignant breast lesions was evaluated and scoring was graded as 0, 1+, 2+, 3+ and 4+. Statistical analysis was performed with Chi-Square test and significant differences were noted between these 3 groups (p value <0.05).Conclusions:VEGF expression correlated well with the grade and stage of tumor indicating that VEGF positive tumors are biologically aggressive and are associated with poor prognosis but little is known about the implication of genetic alterations of VEGF in benign breast lesions.


Author(s):  
Mahbuba Azim Moonmoon ◽  
M. N. Rubaia Islam Bony ◽  
Md. Ubaidul Islam ◽  
Parbati Devnath ◽  
Nahid Safrin

Introduction: Breast cancer is currently one of the leading causes of cancer deaths in women. Early detection and accurate classification of suspicious masses as benign or malignant is important for arriving at an appropriate treatment plan. Elastography has shown potential in differentiating benign from malignant breast tumors. Objective: To evaluate the usefulness of Strain Elastography ultrasound in differentiation of benign and malignant breast masses taken histopathology as Gold Standard. Methods: This cross-sectional study was carried out in the Department of Radiology and Imaging, BIRDEM, Dhaka, from July 2017 to June 2019. A total of 92 female patients with breast masses were enrolled in this study. Strain Elastography Ultrasound and histopathology were done in all these patients. Statistical analyses of the results were obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: The validity test of B-mode ultrasonography for differentiation of benign and malignant breast mass has sensitivity 95.0%, specificity 71.2%, accuracy 81.5% and positive predictive value 71.7% and negative predictive value 94.9%. Strain Score has sensitivity 85.0%, specificity 92.3%, accuracy 89.1%, positive predictive value 89.5% and negative predictive value 88.9%. Strain ratio has sensitivity 87.5%, specificity 94.2%, accuracy 91.3%, positive predictive value 92.1% and negative predictive value 90.7%. The validity test of Combined (B-mode sonography and Elastography) has sensitivity 97.5%, specificity 96.2%, accuracy 96.7%, positive predictive value 95.1% and negative predictive value 98.0%. The areas under the curve (AUCs) from the receiver operating characteristic (ROC) curves were 0.948 for ACR-BIRADS classification, 0.986 for Strain Score, 0.956 for Strain Ratio and 0.990 for combination. Conclusion: The combination of strain elastography with B-mode ultrasonography has the potential to improve the differentiation of benign and malignant breast masses.


2021 ◽  
Vol 15 (10) ◽  
pp. 2772-2775
Author(s):  
Anam Manzoor ◽  
Iqra Rafique ◽  
Sana Naseer

Objective: To assess the diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions taking histopathology as gold standard. Design of the Study: It was a descriptive cross-sectional study. Study Settings: This study was carried out at Department Of Diagnostic Radiology And Diagnostic Imaging Combined Military Hospital, Lahore from January 2017 to June 2017. Material and Methods: A total of 190 patients of age 30-70 years, presenting with palpable breast lesions with BIRAD ≥4 undergoing biopsy under local anesthesia were included. Patients with already diagnosed with breast cancer and recurrent breast lesion were excluded. Then all patients were undergone USG by using a high-resolution unit (PLM703AT) with a linear array probe centered at 7, 5 MHz, along with mammography using mamomet 3000 NOVA SIEMENS, General Electric Medical Systems, Milwaukee. Patients were labeled as positive or negative. Sonomammography findings were correlated with histopathological findings. Results of the Study: In 117 sonomammography positive patients, 107 (True Positive) had malignant breast lesions and 08 (False Positive) had benign on histopathology findings. Among, 75 sonomammography negative patients, 06 (False Negative) had malignant breast lesions on histopathology whereas 69 (True Negative) had benign lesions on histopathology. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions taking histopathology as gold standard was 94.69%, 89.61%, 93.04%, 92.0% and 92.63% respectively. Conclusion: This study concluded that diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions is quite high. Keywords: Breast lesions, malignant, sonomammography, sensitivity.


2015 ◽  
Vol 5 (3) ◽  
pp. 151-156 ◽  
Author(s):  
Tarana Yasmin ◽  
Sohely Sultana ◽  
Mashah Binte Amin ◽  
Syed Shamsul Arephen ◽  
Sania Rafat ◽  
...  

Background: A lump in the breast is a cause of great concern. High frequency high resolution ultrasonogram helps in its evaluation. With major advances in ultrasonographic technology during the past 20 years, ultrasonogram can now distinguish benign and malignant solid breast lumps. Knowledge of the specific benign and malignant ultrasonographic characteristics of breast lumps is imperative for accurate diagnosis and optimal patient management.Objective: To determine the validity of ultrasound in the assessment of palpable breast lump by detecting the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasonogram in distinguishing benign and malignant breast lumps.Materials and Methods: This cross sectional study was done in the department of Radiology and Imaging of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka in collaboration with the department of Pathology of BSMMU for histopathological correlation during July 2008 to June 2009. A total of 100 patients who were clinically suspected of having breast lump were included in this study. Data on clinical presentation, ultrasonographic findings including histopathological reports were collected and documented in structured forms. Analysis was done using SPSS 13.0 version.Results: The study was done in 100 women of 18–70 years of age with mean age 41.46 ± 11.62 years. Breast lumps were found with associated clinical presentation of pain in 26 (26%) cases, discharge in 12 (12%) cases, skin changes in 28 (28%) cases, nipple retraction in 10 (10%) cases, and palpable lymph nodes in 10 (10%) cases. On ultrasonogram, lesions were diagnosed as benign in 62% cases and malignant in 38% cases. Out of sonographically diagnosed 62 benign lesions 58 (93.5%) were also proved benign histopathologically and 4 (6.5%) as malignant. Out of 38 sonographically malignant lesions, 34 (89.5%) were also proved as malignant histopathologically and 4 (10.5%) as benign.Conclusion: Ultrasonographic findings of benign and malignant breast lumps correlated well in most of the cases with the histopathological results. Therefore, it can be concluded that ultrasonogram is a useful imaging tool to discriminate benign and malignant breast lumps and thus we can reduce unnecessary breast biopsies, patient discomfort and anxiety in addition to increase in cost of the patient.J Enam Med Col 2015; 5(3): 151-156


2020 ◽  
Vol 8 (2) ◽  
pp. 105-114
Author(s):  
Ainul Mardhiah ◽  
Nova Hasbani Prima Dewi ◽  
Aminy Aminy

The family planning program also aims to improve the quality of the family in order to generate a sense of security, peace and hope of a better future in realizing the prosperity of birth and inner happiness. Allegedly the factor causing EFA participation in the family planning program is characteristic. The purpose of this research is to know the relationship of attitude and characteristic of Elderly Age Couple (PUS) with participation in family planning program at UPT Puskesmas Sungai Raya Sungai Raya District, East Aceh regency 2018. The research design used was analytic survey with cross sectional design. The population of this study is all Pairs Age of Fertile located in Work Area UPT Sungai Raya Public Health Service Center in January to December 2017 which amounted to 1897 people. Sampling using Slovin formula, obtained as many as 95 samples. The study was conducted from 7-17 July 2018 using questionnaires by interview. Statistical test using chi-square test. Result of research indicate that majority of fertile couple couples (PUS) participate in family planning program as much as 67 respondents (70,5%). Statistically there is relationship of attitude and characteristic of Elderly Age Couple (EFA) with non participation in family planning program in Working Area of UPT Puskesmas Sungai Raya Sungai Raya District of East Aceh Regency 2018 with p value <0,1. It is recommended that the family planning program holders in UPT Puskesmas Sungai Raya Sungai Raya District of East Aceh District to invite cross-sectoral figures to hold meetings to create mini workshop plans at least once a month to increase the participation of the Elderly Age Couple (PUS) in family planning programs. Keyword : Family Planning Program, Attitudes, CharacteristicsABSTRAKProgram KB juga bertujuan untuk meningkatkan kualitas keluarga agar dapat timbul rasa aman, tentram, dan harapan masa depan yang lebih baik dalam mewujudkan kesejahteraan lahir dan kebahagiaan batin. Diduga faktor yang menyebabkan ketidakikutsertaan PUS dalam program KB adalah karakteristik. Tujuan penelitian ini untuk mengetahui hubungan sikap dan karakteristik Pasangan Usia Subur (PUS) dengan keikutsertaan dalam program KB di Wilayah Kerja UPT Puskesmas Sungai Raya Kecamatan Sungai Raya Kabupaten Aceh Timur tahun 2018. Desain penelitian yang digunakan adalah survei analitik dengan rancangan bedah lintang. Populasi dari penelitian ini adalah seluruh Pasangan Usia Subur yang berada di Wilayah Kerja UPT Puskesmas Sungai Raya pada bulan Januari sampai dengan Desember tahun 2017 yang berjumlah 1.897 orang. Pengambilan sampel menggunakan rumus Slovin, didapatkan sebanyak 95 sampel. Penelitian dilaksanakan dari tanggal 7-17 Juli tahun 2018 menggunakan kuesioner dengan cara wawancara. Uji statistik menggunakan uji chi-square. Hasil penelitian menunjukkan bahwa mayoritas Pasangan Usia Subur (PUS) ikut serta dalam program KB yaitu sebanyak 67 responden (70,5%). Secara statistik ada hubungan sikap dan karakteristik Pasangan Usia Subur (PUS) dengan ketidakikutsertaan dalam program KB di Wilayah Kerja UPT Puskesmas Sungai Raya Kecamatan Sungai Raya Kabupaten Aceh Timur tahun 2018 dengan p value < 0,1. Sebaiknya pemegang program KB di UPT Puskesmas Sungai Raya Kecamatan Sungai Raya Kabupaten Aceh Timur agar mengajak tokoh lintas sektor agar mengadakan pertemuan untuk membuat rencana loka karya mini setidaknya satu bulan sekali untuk meningkatkan keikutsertaan Pasangan Usia Subur (PUS) dalam program KB.Kata Kunci : Program KB, Sikap, Karakteristik


2019 ◽  
Vol 6 (1) ◽  
pp. 19-28
Author(s):  
Rakhmie Rafie ◽  
Yusmaidi Yusmaidi ◽  
Mira Fitriyani

Berdasarkan Permenkes 585/1989 dikatakan bahwa informed consent adalah persetujuan yang diberikan oleh pasien atau keluarganya atas dasar penjelasan mengenai tindakan medis yang akan dilakukan terhadap pasien tersebut. Peran dan tanggung jawab dokter terhadap pelaksanaan tindakan medis berdasarkan imformed consent sangat penting untuk mencegah kemungkinan yang akan terjadi kepada pasien nantinya. Pemahaman terhadap informasi yang diberikan dipengaruhi oleh beberapa faktor, diantaranya karakteristik orang tersebut. Survey analitik dengan desain cross sectional dengan wawancara terpimpin menggunakan kuesioner terhadap 100 responden, dan diolah menggunakan analisa univariat dan bivariat dengan uji Chi-Square. Hasil penelitian menunjukkan bahwa: yang berusia dewasa 84 responden (84%) dan yang berusia muda sebanyak 16 responden (16%), laki- laki 63 responden (63%) dan perempuan 37 responden (37%), yang berpendidikan rendah 41 responden (41%) dan yang berpendidikan tinggi 59 responden, yang tidak bekerja 24 responden (24%) sedangkan yang bekerja 76 responden (76%), yang mempunyai pemahaman baik 58 responden (58%) dan yang tidak baik sebanyak 42 responden (42%). Variabel yang terdapat hubungan bermakna dengan pemahaman terhadap persetujuan tindakan medis pada tindakan bedah di RSPBA pada bulan Maret 2015 adalah umur (nilai p value = 0,037) OR = 3.761 dengan nilai Confidence Interval (1.195-11.835)dan pendidikan (nilai p value = 0,00) OR = 8.551 dengan Confidence Interval (3.436-21.285). Sedangkan variabel yang tidak terdapat hubungan bermakna dengan pemahaman persetujuan tindakan medispada tindakan bedah di RSPBA pada bulan Maret 2015 adalah jenis kelamin (nilai p value = 0,987) dan pekerjaan (p value = 0,251). Terdapat hubungan bermakna antara umur dan pendidikan dengan pemahaman terhadap persetujuan tindakan medis pada tindakan bedah di RS Pertamina Bintang Aamin (RSPBA) pada bulan Maret 2015.  


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