Comparison of Physical Examination and Ultrasound in Detecting the T and N Stage of Breast Cancer: A Validation Study

Objectives

The following study is aimed at determining the accuracy and effectiveness of determining the T and N stages of breast cancer through clinical breast examination (CBE) while keeping ultrasound as the standard modality.

Materials and Methods

This retrospective analysis was conducted in the department of surgery at a tertiary care hospital, where a total of 125 patients were enrolled and admitted through OPD and emergency over a period of 6 months. The variables that were included in the study are the following: Name, age, contact number, date of admission, medical record number (MR number), type of breast cancer, physical examination, and ultrasound findings. Data was collected in a pre-designed proforma, added to a Microsoft Excel sheet, and analyzed through SPSS software version 23.0. The data was described in the form of descriptions, charts, and tables.

Results

Out of 125 patients, the tumor size of 85 (68%) patients and the N stage of 60 (48%) patients were almost accurately assessed through CBE in comparison to ultrasound. Lymph nodes could not be palpated on CBE in 39 (31.2%); however, they were identified on ultrasound. Out of fifteen patients in which no mass could be palpated on CBE, ultrasound could identify minute masses in 12 patients. In 28 patients (22.4%), there was an overestimation of tumor size by 1 cm during CBE as compared to ultrasound, and in 2 patients, there was an underestimation by 1 cm.

Conclusion

Undeniably, ultrasound is a more accurate investigation to diagnose and detect the T stage and N stage of breast cancer; however, a proper clinical breast exam (CBE) can also help detect the signs related to breast cancer, hence aiding in early diagnosis and prompt management.