WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Dr. Osama Abbas Ijam, Dr. Montadhar Shaker Al Majidi, Dr. Zinah Abdalrahman Tawfik

ABSTRACT

Background: Breast imaging plays a pivotal role in the early detection and characterization of breast lesions. Mammography and ultrasonography are widely used imaging modalities, while histopathological examination remains the gold standard for definitive diagnosis. Correlating radiological findings with histopathological outcomes is essential for evaluating diagnostic accuracy and optimizing patient management. Objectives: To assess the radiological characteristics of breast lesions detected by mammography and ultrasonography and to determine their correlation with histopathological findings among patients attending Al-Thaqalayn Oncology Hospital in Basra, Iraq. Methods: This retrospective cross-sectional study was conducted at Al-Thaqalayn Oncology Hospital, Basra, Iraq, between 22 April 2024 and 28 February 2026. A total of 300 female patients with breast lesions who underwent mammographic and/or ultrasonographic examination followed by histopathological evaluation were included. Demographic characteristics, imaging findings, BI-RADS categories, and histopathological diagnoses were collected and analyzed. Histopathological examination was considered the reference standard. Statistical analysis was performed using SPSS version 31, and a P value of less than 0.05 was considered statistically significant. Results: The mean age of the patients was 48.7 ± 11.6 years. Malignant lesions accounted for 60.7% of cases, whereas benign lesions represented 39.3%. Invasive ductal carcinoma was the most common malignant lesion (78.0%), while fibroadenoma was the most frequent benign lesion (35.6%). BI-RADS categories 3 and 5 were the most commonly assigned categories (22.0% each). A highly significant association was observed between BI-RADS classification and histopathological diagnosis (P value <0.001). The proportion of malignant lesions increased progressively with increasing BI-RADS category, reaching 98.5% among BI-RADS 5 lesions. Irregular lesion shape, spiculated margins, microcalcifications, and posterior acoustic shadowing were significantly associated with malignancy (P value <0.001). Combined mammography and ultrasonography demonstrated a sensitivity of 96.2%, specificity of 70.3%, positive predictive value of 83.3%, negative predictive value of 92.2%, and overall diagnostic accuracy of 86.0%. Conclusions: Mammography and ultrasonography demonstrated high diagnostic performance in the evaluation of breast lesions. A strong correlation was observed between BI-RADS classification and histopathological diagnosis, supporting the reliability of breast imaging in predicting malignancy and guiding clinical decision-making. Combined imaging modalities remain valuable tools for the early detection and characterization of breast cancer.

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