Clinical, Ultrasonological, Pathological Correlation of Breast Masses

Abstract

QUESTIONS TO BE ANSWEREDIn this retrospective study we have correlated the clinical, ultrasonological and pathological findings of breast masses to answer whether we could rely on ultrasound and Fine Needle Aspiration (FNAC) findings for the further management of patients. MATERIAL AND METHODSThis is a retrospective study done at Vidya Cancer Hospital, Gwalior, Madhya Pradesh, India. This study has included patients from Jan. 2014 to Jan. 2016. The total number of patients is 50. The clinical examination is done by an oncology team which includes a surgical oncologist, medical oncologist, radiation oncologist and gynaecologist. The ultrasound is done by an oncoradiologist. The pathological examination is done by an oncopathologist. The ultrasonology findings assessment is done according to the American College of Radiology, Breast Imaging Reporting and Data System (BI-RADS). The statistical analysis is done by using standard formulas. DISCUSSIONIn our day-to-day practice, we often see so many breast lumps. All the patients and their family members are in great agony. We as clinicians have to give quick results by non-invasive methodology. In today's era nothing could be advocated merely on clinical experience, it has to be evidence based. To create evidence, we have done this study. We found even a good clinical examination and ultrasound by a good team could solve most of the diagnostic dilemmas of breast masses. In our study, the sensitivity and specificity of clinical examination were 100% and 88% respectively. We tried to compare it with other studies, but we were unable to compare it with because of wide variations in those studies for they were either not focusing on clinical examination or it was not a team effort. Yes, we have been able to compare the sensitivity and specificity of ultrasound and FNAC findings. In our study, the sensitivity and specificity of ultrasound was 100% and 88% respectively which was comparable to 95.7% and 89.2% respectively in Lehman et al Study. In our study the sensitivity and specificity of FNAC was 93.3% and 88% respectively, which was 66.6% and 81.8% in Homesh NA et al study. The difference in sensitivity and specificity may be because our pathologist was always in coordination with the clinicians and ultrasonologist. Apart from this, we came across very interesting finding that our pathologist was not able to give any conclusive findings in clinically suspicious an d BIRADS 4 findings. CONCLUSIONThis study has shown that a good team work could do wonders and a good clinical and ultrasonological examination could sort out most of the diagnostic dilemmas of breast masses. FNAC does well in frankly benign and malignant lesions. Any lesion which is suspicious and BIRADS 4 should undergo an upfront biopsy rather than FNAC. Fallacy was the number of patients included in this study was too small to make a final remark and secondly it is not a blinded study.

Improvement in Cohesive Properties of Adhesion Systems Using Movable Cross-Linked Materials with Stress Relaxation Properties

“…A long lifetime adhesion system needs to have a high adhesion strength, high toughness, and the ability to endure constant and sudden deformation. Conventional structural adhesives based on covalent bonding and van der Waals interactions have already been proven to achieve high adhesion strength. , However, due to the nature of covalent bonding, which causes the covalent adhesives to have low stretchability, adhesives using covalent bonds are poor in toughness and continuous stress resistance . This disadvantage affects their performance in many situations such as in the bonding of dissimilar materials with different linear expansion coefficients.…”

“…Conventional structural adhesives based on covalent bonding and van der Waals interactions have already been proven to achieve high adhesion strength. 1,2 However, due to the nature of covalent bonding, which causes the covalent adhesives to have low stretchability, adhesives using covalent bonds are poor in toughness and continuous stress resistance. 1 This disadvantage affects their performance in many situations such as in the bonding of dissimilar materials with different linear expansion coefficients.…”

Ab initio Modeling of Hydrogen Bonding of Remdesivir and Adenosine with Uridine

“…The presence of ribose sugar is crucial for the shape and structure of RNA. [47,48] However, the influence of sugar on the base pair H-bonds is largely missing from the literature. In this study, we also aim to bridge the gap by explicitly considering the base pairs attached to the ribose sugar.…”

“…The presence of ribose sugar is crucial for the shape and structure of RNA [47,48] . However, the influence of sugar on the base pair H‐bonds is largely missing from the literature.…”