An evaluation of the concordance between mammography and histopathology findings in women with breast lesions at Mankweng Hospital, Limpopo Province

Abstract

BACKGROUND: Breast lesions in women can be caused by any disease process or physical injury occurring at any age. The lesions may be benign (non-cancerous) or malignant (cancerous) with the cancerous lesions having a more ominous implication when diagnosed. Mammography is usually performed as the initial investigation for breast cancer followed by histopathology as the confirmatory investigation. Therefore, the agreement between mammography and histopathology findings is critical in determining the correct management of patients with breast lesions. PURPOSE: To evaluate the concordance between mammography and histopathology findings in women with breast lesions at Mankweng Hospital. METHOD: Data was collected at Mankweng Hospital from the records of patients who underwent mammography and subsequent histopathological diagnosis. The qualifying data was entered onto Microsoft Excel and data analyses were conducted in STATA version 15. Continuous variables such as age, were summarised by means and standard deviations. Categorical variables were described with frequencies and percentages. Agreement between mammography and histological diagnoses were assessed by Kappa statistics. Performance of mammograph as a screening test for malignant breast disease using histology as the gold standard was evaluated by computing sensitivity, specificity, negative and positive predictive values. A p-value of ≤0.05 was considered as statistically significant. RESULTS: Total of 41 patient records were part of the study. Findings indicated a high degree of concordance between mammogram findings and histology report when using a BIRADS cut-off of 5. A lower but still statistically significant concordance was realised when using BIRADS cut-off of 4. CONCLUSION: The study demonstrated agreement between mammography and histopathological diagnosis of breast lesions categorized as BIRADS 4 and 5. The PPV findings are comparable with those of ACR BIRADS guidelines. The result demonstrates that reporting of mammography findings of breast lesions according to BIRADS lexicon in Mankweng Hospital is in keeping with standardized BIRADS reporting guidelines.