Accuracy of Breast Cancer Diagnosis by Physical, Radiologic and Cytologic Combined Examinations

Abstract

Physical examination, mammography and fine-needle aspiration cytology were performed in 1498 consecutive cases with a solitary solid lump of the female breast. The intent was to verify the validity of this diagnostic triplet in the accuracy of the preoperative diagnosis of breast cancer. Clinically sure cancers were excluded from the study. The collected data were evaluated in terms of sensitivity, specificity and predictivity of any procedure alone or in combination. In 1138 cases confirmed by histology (514 carcinomas and 669 benign or non-neoplastic lesions), the physical examination and mammography were very sensitive (respectively 96% and 84%) but with a high rate of false-positive reports (respectively 20% and 18%). The cytologic diagnosis was less sensitive (65%), mostly due to many inadequate smears, but highly specific (93%) and predictive for malignancy (99%) when the cytologic report was frankly positive. Any single procedure improved the overall sensitivity, and taken together this triplet appears to be the most effective noninvasive diagnostic combination that provides in a short time with minimal cost and discomfort, a diagnosis of certain malignancy in about 50% of carcinomas with a predictivity close to 100%, when cytology detected malignancy.

Investigation of Breast Lumps: An Evaluation

“…Though the sensitivity was less than PE, specificity was reasonable high (92.6%). These results are comparable to the results of the studies carried out by other authors [2][3][4][5][6]. It is recommended that all well defined dominant lumps of breast which are benign/equivocal on PE should be subjected to USS for further tissue characterization.…”

“…USS of breast is highly accurate in detecting cysts as small as one em in diameter [4]. At the same time, its value in defining the lesions is better in younger women with dense breast.…”

Triple Test Score for the Evaluation of Invasive Ductal and Lobular Breast Cancer

“…Several studies have proved that compared to the most common ductal carcinoma its prognosis is better [6,7], specially because its lower proliferative activity [8] but diffuse spreading, multifocality [9] makes diagnosis more difficult. In the past decades mammography, palpation and cytology examination were considered as "triple test" [10,11] and several papers have proved its usefulness [11,12] and cost-effectiveness [13]. The score created from the sum of numeric test results of different diagnostic tools is sensitive and accurate to predict the benign or malignant behaviour of the laesion [14].…”

Immunocytochemistry with monoclonal antibody B72.3 applied to a spectrum of benign and malignant breast aspirates — strengths and pitfalls

“…However, the pathologist must recognize the pitfalls of the false negatives and false positives associated with immunocytochemistry. In addition, it must be recognized that one is dealing with a laboratory test which should never be looked at in an isolated fashion: rather, the results must be interpreted in context of the entire clinical picture (physical examination, mammography, and cytology) [14]. Our initial efforts have been directed at understanding all of the strengths and weaknesses of MAb B72.3 used as a diagnostic adjunct to fine needle aspiration cytology.…”