Mammography and Ultrasonography Reports Compared with Tissue Diagnosis - An Evidence Based Study in Iran, 2010

  • Published : 2012.05.30


Background: Breast cancer is the most prevalent cancer and the fifth cause of cancer death in Iranian women. Early detection and treatment are important for appropriate management of this disease. Mammography and ultrasonography are used for screening and evaluation of symptomatic cases and the main diagnostic test for breast cancer is pathological. In this study we evaluated mammography and ultrasonography as diagnostic tools. Methods: In this cross-sectional study 384 mammography and ultrasonography reports for 255 women were assessed, divided into benign and malignant groups. Suspected cases were referred for pathology evaluation. The radiologic and pathologic reports were compared and also comparison was performed based on age groups (more and less than 50 years old), history of breastfeeding and gravidity. Statistical analysis was performed by SPSS. Results: The mean ages of malignant and benign cases were $49{\pm}11.6$ and $43{\pm}11.2$ years, respectively. Sensitivity and specificity for mammography were 73% and 45%, respectively. Sensitivity and specificity for ultrasonography were 69% and 49%, respectively. There were statistical differences between specificity of mammography in patients based on factors such as history of gravidity, breastfeeding and sensitivity in patients equal or more than 50 years old and less. Conclusion: Factors affecting different results in mammography and ultrasonography reports were classified into three groups, consisting of skill, experience and training of medical staff, and setting of instruments. It is recommended that health managers in developing countries pay attention the quality of setting and man power more than current status. Policy-makers and managers must establish guidelines regarding breast imaging in Iran.


  1. Akbari A, Razzaghi Z, Homaee F, et al (2010). Parity and breastfeeding are preventive measures against breast cancer in Iranian women. Breast Cancer, 18, 51-5.
  2. Akbari ME, Khayamzadeh M, Abachzadeh K, et al (2008). Iran cancer report. Cancer Research Center. Shahid Beheshti University of Medical Sciences. Tehran, Qom: Darolfekr.
  3. Anderson T, Sufi F, Ellis I, Sloanet J, Moss S (2002). Implications of pathologist concordance for breast cancer assessments in mammography screening from age 40 years. Hum Pathology, 33, 365-71.
  4. Attarian H, Pirzadeh A, Rezvani H, et al (2011). Clinicopathologic manifestations of Iranian patients with breast cancer. Pakistan J Med Sci, 27, 182-5.
  5. Berg W, Blume J, Cormack J, et al (2008). Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA, 299, 2151-63.
  6. Boyle P, Levin B (2008). World Cancer Report. Lyon: IARC Press-WHO.
  7. Brunicardi FC, Andersen DA, Timothy R et al (2010). Schwartz's Principles of Surgery. Eight ed.
  8. Cancer Office CDC. Iranian Annual of Cancer Registration Report 2007-2008. 2008, Tehran: Ministry of Health and Medical Education
  9. Ciatto S, Rosselli T, Catarzi S, Morrone D (1994). The contribution of ultrasonography to the differential diagnosis of breast cancer. Neoplasma, 41, 341-5.
  10. Crystal P, Stano SD, Shcharynski S, Koretz M (2003). Using sonography to screen women with mammographically dense breasts. Am J Roentgenol, 181, 177-82.
  11. Devolli-Disha E , Manxhuka-Kerliu S,Ymeri H , Kutllovci A (2009). Comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density. Bosn J Basic Med Sci, 9, 131-6.
  12. Elmore J, Armstrong K, Lehman C, Flecher S (2005). Screening for breast cancer. JAMA, 293, 1245-56.
  13. Ghebrehiwet M, Paulos E, Andeberhan T (2010). The use of sonography and mammography in the evaluation of eritrean women with breast pain. J Eritrean Med Assoc, 3, 8-11.
  14. Houssami N, Ciatto S, Irwing L, Simpson JM, Macaskill P (2002). The comparative sensitivity of mammography and ultrasound in women with breast symptoms: an age-specific analysis. Breast, 11, 125-30.
  15. Kacl G , Liu P, Debatin J, et al (1998). Detection of breast cancer with conventional mammography and contrast-enhanced MR imaging. Eur Radiol, 8, 194-200.
  16. Khadivi R, Harrirchi I, Khosravi Z, Akbari ME (2008). Ten year breast cancer screening and follow up in 52200 women in Shahre- Kord, Iran (1997-2006). Iranian J Cancer Prev, 1, 73-7.
  17. Malur S, Wurdinger S, Moritz A, Michels W, Schneider A (2000).Comparison of written reports of mammography, sonography and magnetic resonance mammography for preoperative evaluation of breast lesions, with special emphasis on magnetic resonance mammography. Breast Cancer Res, 3, 55-60.
  18. Nguyen M, Larocque D, Paquette D, Irace-Cima A (2009). Quebec breast cancer screening program. A study of the perceptions of physicians in Laval, Que. Can Fam Physician, 55, 614-20
  19. Prasad S N, Houserkova D (2007). A comparison of mammography and ultrasonography in the evaluation of breast masses. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 151, 315-22.
  20. Youk J, Kim E (2010).Supplementary screening sonography in mammographically dense breast: pros and cons. Korean J Radiol, 11, 589-93.

Cited by

  1. Comparative Efficacy of Four Imaging Instruments for Breast Cancer Screening vol.16, pp.15, 2015,
  2. Cost-Effectiveness Analysis of Breast Cancer Screening in Rural Iran vol.17, pp.2, 2016,