Correlation of Clinical Examination with Radiological Imaging in the Diagnosis of Painful Breast Lumps: A Prospective Study

Abstract

Painful breast lumps are a common reason for clinical visits among women leading to significant anxiety. Although triple assessment (clinicalexamination (CE), ultrasonography (USG), and tissue sampling) is considered the diagnostic gold standard test, routine biopsy may beunnecessary in these females with benign clinical feature and imaging. This study evaluates the diagnostic accuracy of CE and USG in womenaged 18–35 years presenting with painful breast lumps and correlates findings with pathological results. This prospective observational studyincluded 65 females aged 18–35 years with painful breast lumps. All participants underwent clinical examination, ultrasonomammography using BI-RADS classification, and fine-needle aspiration cytology (FNAC). Clinical and radiological diagnoses were correlated with histopathologyfindings. Sensitivity, specificity, predictive values, and diagnostic accuracy were calculated, and associations were analyzed using chi-square and Z-tests. The majority of lumps were benign on CE and USG. Histopathology confirmed benign lesions in 98.5% of patients, with fibroadenosis(56.9%) and fibroadenoma (29.2%) being most common. Only one patient (1.5%) had malignancy. CE demonstrated a sensitivity of 100%,specificity of 95.3%, and diagnostic accuracy of 95.3%. Ultrasonography showed 100% sensitivity, 100% specificity, and 100% diagnosticaccuracy with perfect concordance with biopsy (p < 0.0001). Combined CE and USG accurately identified benign lesions in 95.3% of cases,and all BI-RADS IV lesions were malignant. Painful breast lumps in young women are overwhelmingly benign. Ultrasonography, combinedwith clinical examination, provides excellent diagnostic accuracy that can reliably identify benign lesions, potentially reducing the need forroutine biopsy. Selective use of tissue sampling, reserved for suspicious CE or BI-RADS IV/V findings, may reduce patient anxiety, proceduralrisks, and healthcare costs without compromising cancer detection.