Enhancing Diagnostic Accuracy in Symptomatic Breast Diseases: The Role of Ultrasound with Mammography

Abstract

Objectives: To evaluate the diagnostic performance of mammography and ultrasound, individually and in combination, in patients presenting with symptomatic breast disease.

Methodology: A cross-sectional validation study was conducted in the Department of Surgery at a PAF hospital in Islamabad, affiliated with Air University, from January 2025 to August 2025. A total of 120 female patients with breast symptoms underwent standard two-view mammography and targeted breast ultrasound. Imaging findings were categorized using the BI-RADS classification and correlated with histopathology, which served as the gold standard. Diagnostic parameters, including sensitivity, specificity, predictive values, and overall accuracy, were calculated.

Results: The mean age of the patients was 44.2 ± 10.8 years, with the majority belonging to the 41–50-year age group. Mammography demonstrated a sensitivity of 76.2% and a specificity of 79.5%, while ultrasound showed a sensitivity of 90.5% and a specificity of 85.9%. When both modalities were combined, sensitivity increased to 95.2%, specificity to 91.0%, and overall diagnostic accuracy to 92.5%. The negative predictive value was highest for the combined approach (97.3%), thereby minimizing false-negative results.

Conclusion: The combination of ultrasound with mammography significantly improves diagnostic accuracy in symptomatic breast disease compared with either modality alone and should be incorporated into routine clinical practice.