Correlation of Histopathology and Radiological Findings Among the Diverse Breast Lesions in a Tertiary Care Centre

Introduction Breast lumps in any age group are addressed cautiously to exclude the possibility of breast cancer. The clinical approach to breast lumps involves the "triple test" for cancer screening. The triple test includes clinical examination, imaging (mammogram or ultrasonogram), and tissue sampling (fine needle aspiration cytology (FNAC) and core needle biopsy). These tests happen in a sequential process, and it is important that their findings support the final diagnosis for accurate management of the patient. Aims and objectives This study aims to determine the correlation between the histopathological and radiological findings among the various breast lesions and describe the spectrum of breast lesions received in our center. Methods This is a retrospective observational study for a period of three years, from January 2020 to December 2022. The study included 400 patients who had undergone ultrasonography or mammograms for breast lumps, FNAC, core needle biopsy, or surgical resection. The data collected was analyzed for concordance and discordance status. Results A total of 400 cases were reviewed. There were 238 (59.5%) histologically confirmed benign breast lesions and 162 (40.5%) malignant lesions with their corresponding BI-RADS (Breast Imaging Reporting and Data System) scores. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for the imaging modalities (ultrasonogram and mammogram) in diagnosing breast lesions were 95.06%, 94.96%, 92.77%, 96.58%, and 95%, respectively, which were comparable with other similar studies. The biological and immunohistochemical factors of all the invasive carcinomas were studied in detail. Conclusions Imaging modalities (ultrasonogram or mammogram) have good sensitivity and specificity in diagnosing breast lesions and can be reliably used as a preliminary test in breast lump evaluation. The BI-RADS score is a reliable indicator and can be considered for the effective follow-up or intervention of the breast lesion. In discordant cases, a repeated core needle biopsy or excision has to be recommended, as pathological diagnosis is the cornerstone of effective management. A good rapport between the surgeon, radiologist, and pathologist aids in effective feedback and learning for achieving diagnostic accuracy.