Assessing the Accuracy of Ultrasonography and Biopsy Necessity in the Management of Breast Lumps in Women Less than 40 Years

Abstract

Background: Following recommended guidelines, palpable breast lumps in young women should be subjected to clinical–radiologic evaluation and tissue diagnosis where necessary. However, in our local practice, most benign breast lumps are also subjected to excision biopsy. Ultrasonography is the modality of choice in the evaluation of palpable breast lumps in young women. Aim: This study aims to determine the accuracy of ultrasonography and the necessity of tissue biopsy in the management of palpable breast lumps in women less than 40 years of age and to determine lesions that can safely be managed conservatively based on histological diagnosis. Materials and Methods: This was a prospective cross-sectional study of 87 adult females who had breast US and biopsy for palpable breast lumps in a tertiary healthcare center over a period of 10 months (July 2020–May 2021). Results: The age range of the women was 18–39 years (mean 27.9 ± 7.09 years). Benign lesions were noted in 86.2% of patients. No malignancy was detected in women < 25 years. Ultrasonography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 93.4%, 70.6%, 100%, and 94.3%, respectively, in differentiating benign from malignant breast lumps following tissue diagnosis. Conclusion: Ultrasonography and tissue biopsy are vital in the evaluation of breast lumps in women less than 40 years of age. Most (86.2%) of the lumps were benign, and no malignancy was detected in women < 25 years. The high accuracy of ultrasonography in distinguishing benign from malignant lesions suggests the need for conservative management of benign lumps in young women.