Browsing by Author "Jha, Anamika"
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Publication Comparison of Sonographic Findings with Diagnostic Mammography(Nepal Health Research Council, 2024) Joshi, Birendra Raj; Paudel, Bishnu; Jha, AnamikaBackground: Breast cancer is the leading female cancer worldwide with a high mortality rate. Early detection of the suspicious lesion is crucial for better prognosis. Higher breast density decreases the sensitivity of mammogram. Ultrasound can differentiate between cystic and solid masses and further characterize these as benign or possibly malignant. Our objective was to compare the findings of sonography with diagnostic mammography. Methods: This was a cross sectional study including 125 females who underwent diagnostic mammogram in a tertiary care center. The mammograms were evaluated and the patients were scanned by ultrasound and categorized as per ACR- BIRADS category. The findings of diagnostic mammography were compared with that of ultrasonography using SPSS version 25. Results: The heterogeneously dense breast in diagnostic mammography corresponded to the heterogenous- fibroglandular breast in ultrasonography. In majority, ultrasound increased the BIRADS category for the lesion than designated by the diagnostic mammography. It was particularly useful for category 0 and 3 lesions which were indeterminate and required further imaging. Conclusions: Ultrasound was useful in evaluation of dense breasts with ACR-BIRADS 0 and 3 in diagnostic mammogram. For category 3 and 4 in diagnostic mammogram, ultrasound showed category 1 or 2 lesions which aided to alleviate patient anxiety and avoid unnecessary biopsies. With emerging technological advances in ultrasound, it can used as a powerful tool for breast lesion detection and patient management. Keywords: Breast density; diagnostic mammogram; ultrasonography.Publication Sonography as an Adjunct to Digital Mammography in Patients with Dense Breasts(Nepal Health Research Council, 2024) Jha, Anamika; Regmi, Pradeep Raj; Pradhan, Huney; Thakur, Minaxi; Joshi, Birendra RajBackground: Dense breasts are associated with an increased risk of cancer and also mask lesions on mammograms. In our study, we evaluated the role of sonography as an adjunct to digital mammography in patients with dense breasts. Methods: Sonography of 676 female patients with American College of Radiology category C or D mammographic density was done in this prospective cross-sectional analytical study in the Department of Radiology, Tribhuvan University Teaching Hospital. The final imaging diagnosis was classified as per the American College of Radiology Breast Imaging Reporting and Data System categories. Tissue diagnosis was obtained in patients with sonographic category 3 solid lesions larger than 3 cm, category 4 and 5 lesions. The data were tabulated and analyzed using Statistical Package for Social Service (SPSS) for Windows version 22. Results: Additional sonography confirmed all BIRADS 1 mammograms as normal or benign, 95.7 % (112) of inconclusive, and 82.8% (n=135) of BIRADS 3 ones as benign. It had higher sensitivity and negative predictive value (100%) than mammography with similar accuracy. Most patients (479, 70.9%) had diagnostic indications. There were 540 (79.9%) cases in ACR BIRADS category c. A final diagnosis of benign (316, 46.7%) was most common, followed by normal (293, 43.4%) and malignant (67, 9.9%). The majority of the malignant lesions were Invasive Ductal Carcinoma (59, 88%). Conclusions: Additional sonography confirmed mammography findings as normal, benign, or suspicious for malignancy, definitely described morphology and extent of mass, and also guided biopsy. It had higher sensitivity than mammography in dense breasts. Keywords: Breast density; mammography; ultrasonography mammary.