Aim: Aim of the study is to evaluate breast masses using mammography (MG) and ultrasonography (USG) independently and in combination.Materials and methods: Our study group consisted of 62 female patients, with breast symptoms such as palpable lumps, pain in the breast and nipple discharge who were examined prospectively over a period of 6 months.All 62 patients were examined by both MG and USG independently. Fine needle aspiration cytology (FNAC) or core cut biopsy was done according to the fi ndings of MG and USG and then the results were correlated with each modality fi nding.Results: According to this study MG showed an effi ciency of 81.8 % compared to 95.5 % for USG in detecting fi brocystic mastitis. However their combined approach resulted in 100 %. In the case of fi broadenomas, MG showed 75 % effi ciency and USG only 35 % and the combination resulting in 93.7 %. For carcinomas, MG had an effi ciency of 77.8 % and USG 55.6 %, but the combination had an effi ciency of 98.1 %. Overall, the histopathological results when correlated with each modality fi nding showed that MG had an effi ciency of only 77.4 % and USG only 69.8 % when used alone in detecting these lesions of the breast compared to an effi ciency of 98.1 % obtained by their combined approach. In our study, we showed that there was no signifi cant diff erence in sensitivity between MG and USG (p = 0.3768) but there was signifi cant diff erence in MG alone and MG-USG combination (p = 0.0015) and USG alone and USG-MG combination (p = 0.0001).Conclusion: Our study confi rmed that combined MG and USG had higher sensitivity rate than the sensitivity rate observed for either single modality. The diagnostic accuracy for carcinomas of the breast appear to improve when MG was combined with USG, even in cases which showed no evidence of microcalcifi cation or other signs of abnormalities. Our study implies that, USG may be the only viable modality in pregnant and lactating women as it does not involve ionizing radiation and also in dense breast tissue, as density is a limiting factor for MG.

Background: Breast cancer is the most common type of cancer in women worldwide. Mammography is considered the "gold standard" in the evaluation of the breast from an imaging perspective. Apart from mammography, ultrasound examination and magnetic resonance imaging are being off ered as adjuncts to the preoperative workup. Recently, other new modalities like positron emission tomography, 99mTc-sestamibi scintimammography, and electrical impedance tomography (EIT) are also being off ered. However, there is still controversy over the most appropriate use of these new modalities. Based on the literature, this review evaluates the role of various modalities used in the screening and diagnosis of breast cancer.Methods and Results: Based on relevant literatures this article gives an overview of the old and new modalities used in the fi eld of breast imaging. A narrative literature review of all the relevant papers known to the authors was conducted. The search of literatures was done using pubmed and ovid search engines. Additional references were found through bibliography reviews of relevant articles. It was clear that though various new technics and methods have emerged, none have substituted mammography and it is still the only proven screening method for the breast as of date.Conclusion: From the literature it is clear that apropos modern radiology's impact on diagnosis, staging and patient follow-up, only one imaging technique has had a signifi cant impact on screening asymptomatic individuals for cancer i.e.; low-dose mammography. Mammography is the only screening test proven in breast imaging. Positron emission tomography (PET) also plays an important role in staging breast cancer and monitoring treatment response. As imaging techniques improve, the role of imaging will continue to evolve with the goal remaining a decrease in breast cancer morbidity and mortality. Progress in the development and commercialisation of EIT breast imaging system will defi nitely help to promote other systems and applications based on the EIT and similar visualization methods. Breast ultrasound and breast magnetic resonance imaging (MRI) are frequently used adjuncts to mammography in today's clinical practice and these techniques enhance the radiologist's ability to detect cancer and assess disease extent, which is crucial in treatment planning and staging.

Electrical impedance could be used as an adjunct to Mammography and Ultrasonography for breast cancer detection. However, the differentiation of malignant from benign lesions based on impedance measurements needs further investigation. Multifrequency electrical impedance imaging appears the most promising for detecting breast malignancies but methodological improvements need to be made to realise its potential.

Aims:To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnosis of BI-RADS-5 type of microcalcifi cations of the breast, to compare the size of the microcalcifi cation lesions using mammography (MG) and MRI, and to determine the value of MRI in surgery for microcalcifi cations. The study also determines the morphology of microcalcifi cation lesions, assesses kinetic curves and compare MRI features of ductal carcinoma in situ (DCIS) for diff erent histopathological grades.Methods: Our group consisted of 32 patients with mammographically detected BI-RADS 5 microcalcifi cations. The MRI was done in this group of women which was later followed by stereotactic vaccum-assisted biopsy (SVAB). Surgery was performed on all patients with a biopsy that resulted in a diagnosis of breast cancer or atypical ductal hyperplasia (ADH).Results: Of our group of 32 patients, there were 35 mammograhically detected microcalcifi cation lesions, 32 DCIS, one ADH and two benign fi ndings according to the fi nal histology.The microcalcifi cation lesions were larger using MRI than in MG in 10 women. We diagnosed DCIS multifocality in 6 women and bilateral carcinoma in one woman. As with kinetic curve assessment, we found in 67 % of DCIS a rapid rise, 27 % a moderate and in 6 % a slow initial rise. With the pattern of enhancement in the delayed phase, we found in 30 % of DCIS a washout pattern, 67 % a plateau and in 3 % a persistent pattern. Noted diff erence between high and low grade DCIS was confi rmed.Conclusions: MRI sensitivity in the detection of DCIS was 94 % in our group of patients and was the sole evidence for detection of multifocality and bilateral incidence of carcinoma. In 26 % of women the outcome of MRI was the most important for converting breast conserving surgery to mastectomy.

Aim: To present a case of pseudoangiomatous stromal hyperplasia (PASH) and its fi ndings under 1. mammography -MG, 2. ultrasonography -USG and 3. magnetic resonance imaging -MRI.Materials and methods: A woman 39 years of age with a history of mass in her right breast of 3 months duration was subjected to a routine examination of the mass using MG & USG. According to the modality fi ndings a core cut biopsy was done following which the samples were send for histological analysis. Later, MRI was done as advocated by the surgeon to get a better picture of the extent of the lesion prior to surgery.Results: Bilateral mammogram views revealed in the patient's right breast a huge well-bordered tumour of lobulated contour without halo sign. Sonography revealed a big well-demarcated tumour in the central part of the right breast which was cystic and lobulated in shape. Histological analysis of the sample confi rmed pseudoangiomatous stromal hyperplasia (PASH). MRI under a breast array coil revealed a mass of 85×75×35mm in the right breast. Finally, based on the clinical, radiological and histological report the mass was diagnosed as benign and despite the massive size of the mass, tumour excision alone was done and not mastectomy. The right breast after the huge tumour excision was almost normal in size compared to the left.Conclusion: PASH should be included in the diff erential diagnosis of a circumscribed or partially circumscribed mass, especially in the pre-menopausal female population. These benign masses often grow over time and can recur locally. Radiological diagnosis of PASH is usually done by MG and USG followed by core cut biopsy for histological analysis. However great the mass is, excision only of the tumor mass is recommended and not mastectomy.