The Accuracy of Breast Cancer Diagnostic Tools.

Abstract

Background Breast cancer (BC)remains a significant health concern,leadingtoillnessanddeathamong womenglobally. Itisessential to detectBCearly usingimagingtechniquesthataccurately reflectthe final pathology, guiding suitable intervention strategies. Objectives This study aimed toevaluatetheagreementbetween radiological findings and histopathological resultsinBCcases. Methods We conducted aretrospective reviewofbreast core needle biopsies (CNBs)inwomenover a six-year period (2017-2022) at Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. The pathologicaldiagnoses were compared with thefindingsfrompreceding radiological investigations.We also compared the tumour sizes inthe resection specimenswiththeir radiologicalcounterparts. Results A total of 641 cases were includedin the study.Ultrasound (US),mammography,andmagnetic resonance imaging (MRI)yieldeddiagnostic accuracies of 85%, 77.9%, and 86.9%,respectively. MRIhadthe highest sensitivityat72.2%, while US hadthe lowestat61%. MRI provided the best agreementwiththefinalresected tumor size. By contrast,mammographytended to overestimate the size (41.9%), and US most frequently underestimated it(67.7%).The connectionbetween basal-like molecular subtypes and the Breast Imaging Reporting and Data System (BIRADS)-5 classifications wasonlystatistically significantfor MRI (p=0.04). The luminal subtypewas more likely to showspeculation in mammography.Meanwhile,BIRADS-4revealedaconsiderablenumber of benign pathologiesacrossall the threemodalities. Conclusions MRIdemonstrated thehighestaccuracy,sensitivity, specificity,andpositive predictive value (PPV) fordiagnosingandestimating the tumorsize.Mammographyoutperformed US in terms of sensitivityandyielded thehighestnegative predictive value (NPV). US, meanwhile, offered superiorspecificity, PPV,and accuracy. Therefore, combiningthese diagnostic methods could yield significant benefits.