ASSESSMENT OF DIAGNOSTIC ACCURACY OF CLINICAL EXAMINATION AND ULTRASONOGRAPHY IN DETECTING BREAST CANCER IN KIGALI REFERRAL HOSPITALS

Abstract

Background: Breast cancer remains a major public health issue in Rwanda, with high mortality rates largely due to late-stage diagnosis.

Aim: This study aimed to assess the accuracy of clinical breast examination (CBE) and ultrasonography in diagnosing breast cancer among patients at Kigali referral hospitals.

Methods: A retrospective cross-sectional study was conducted using a sample of 286 patients, determined via Clinical Breast Examination and selected through simple random sampling. Data on findings, breast ultrasound results, and histopathology outcomes were collected using a checklist. Histopathology served as the gold standard. T-test statistics were used to test three hypotheses at the 0.05 level of significance.

Results: Clinical breast examination showed 70.8% sensitivity, 86.7% specificity, and 77.6% overall accuracy. Sensitivity and specificity of clinical breast examination did not differ significantly in their influence on breast cancer detection in the sampled patients (t = 1.462; p = 0.145). Breast ultrasound had a sensitivity of 93.4%, specificity of 84.1%, and an overall accuracy of 88.1%. Both sensitivity and specificity contributed similarly to the diagnostic capability of breast ultrasonography in detecting breast cancer within the studied referral hospitals (t = 0.794; p = 0.331). Clinical breast examination and breast ultrasound demonstrate comparable predictive performance in detecting breast cancer within the studied referral hospitals (t = 1.248; p = 0.213).

Conclusion: Clinical breast examination demonstrated a high sensitivity, specificity of 86.7% and overall accuracy indicating effective identification of most breast cancer cases. Additionally, breast ultrasound also exhibited a high sensitivity, specificity and overall accuracy confirming its effectiveness in accurately detecting breast cancer and correctly identifying benign cases, highlighting the potential of breast ultrasound as a reliable diagnostic tool.

Recommendations: Access to ultrasound services should be expanded particularly in underserved areas; integrating into primary healthcare for early detection and management of breast cancer.