Table of Contents
ISRN Oncology
Volume 2013, Article ID 257942, 6 pages
Clinical Study

Are Both Ultrasonography and Mammography Necessary for Cancer Investigation of Breast Lumps in Resource-Limited Countries?

1Program in Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
2Department of Nursing, Uttaradit Hospital, Uttaradit 53000, Thailand
3Department of General Surgery, Nakon Swan General Hospital, Nakon Swan 60000, Thailand
4Department of General Surgery, Uttaradit General Hospital, Uttaradit 53000, Thailand
5Department of General Surgery, Lampang General Hospital, Lampang 52000, Thailand
6Clinical Epidemiology Society, Chaing Mai 50200, Thailand
7Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

Received 27 April 2013; Accepted 28 July 2013

Academic Editors: G. Gatti and A. Goussia

Copyright © 2013 Rungnapa Chairat et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To reevaluate the diagnostic value of breast imaging in the diagnosis of breast cancer in areas where health resources are limited. Methods. Patients were women presenting with breast lumps in two university-affiliated tertiary hospitals, Thailand, during 2006 and 2010. Clinical data were abstracted from the breast cancer registration database and patient records. The diagnostic predictive ability of ultrasonography and mammography was obtained from logistic regression analysis and presented with areas under the receiver operating characteristics (AuROCs) curves. Results. Among 3129 breast lumps (3069 women), 854 were diagnosed with breast cancer by certified pathologists. Age and size of lumps alone already predicted cancer correctly in 77.45% (AuROC = 77.45). Additional ultrasonography increased the prediction to 96.22% ( ). Additional mammography also increased the prediction to 95.99% ( ). Performing both imaging modalities did not increase the prediction clinically (0.01%–0.24%). More accurate prediction (2.07%–2.21%) may be added by fine needle aspiration cytology (FNAC). Conclusions. Breast imaging is still valuable in settings where health resources are limited. Single breast imaging (only either ultrasonography or mammography) is adequate for cancer diagnosis. It is therefore unnecessary to perform both imaging modalities. Accuracy of the diagnosis may be improved by FNAC, if available.