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Home > Prediction of Breast Tumor Size by Ultrasound: A Comparison With Pathology

Prediction of Breast Tumor Size by Ultrasound: A Comparison With Pathology

Thesis Info

Author

Wanyonyi, David Toyis

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2014

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728058040

Similar


Background: Tumor size is one of the most important prognostic factors in breast cancer and its accurate assessment is critical in planning appropriate treatment. Although histology is often regarded as the definitive way of establishing tumor size, radiological techniques, particularly ultrasonography, are usually relied upon to give an estimate of the tumor size for prognostication and treatment planning. Correlations between mammography, ultrasonography, magnetic resonance imaging (MRI) and pathology size have been performed in different populations with varying results however no prospective study has been done to establish the agreement between sonographic tumor size and histopathological tumor size in our population. Objectives: The main objective of this study was to determine whether or not there was a difference between the tumor size on ultrasound and tumor size on histopathology. The relationship between tumor size on ultrasound and tumor size on histopathology was also assessed. Methods: This was a prospective, observational survey. Women undergoing preoperative ultrasound for suspicious breast masses followed by lumpectomy or mastectomy were recruited into the study. The tumor sizes measured to the nearest millimeter on ultrasound and on histopathology were recorded side by side in a data sheet. Analysis: The mean difference between the two sets of measurements was assessed using a paired t-test. The paired measurements were also plotted on a scatter diagram and linear regression analysis performed to establish their degree of correlation. An equation for predicting the histopathological tumor size from the sonographic tumor size was given along with 95% confidence intervals. Outcomes: Ultrasound tended to underestimate the tumor size and the mean difference between ultrasound and histopathology was 4.3 mm (95% confidence interval of 0.8 mm to 7.8 mm; p-value of 0.0196). The equation y = 1.1758x + 0.126 best predicted the histopathology size from the ultrasound size although this did not differ significantly from the line of equality. Discussion: This study demonstrated that tumor size on ultrasound differed significantly from that on histopathology, similar to findings from previous studies. However, due to the wide variability in the size differences, it remains difficult to accurately predict the histopathological size for an individual tumor. Recommendations: Clinicians managing patients with breast cancer need to be aware that while ultrasound may be used to estimate tumor size, this estimate might differ significantly from the histopathological measurement.
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اندھیروں میں کھلا کیسا دریچہ

اندھیروں میں کھلا کیسا دریچہ
حرا سے روشنی دیتا دریچہ

نہ جانے کب کہیں سے نعت اُترے
خیالوں کا کھلا رکھا دریچہ

سدا آئے صدا صلِّ علیٰ کی
نبیؐ کے ذکر کا رسیا دریچہ

ہوائے سبز آتی ہے وہاں سے
بنا ہے گنبدِ خضرا دریچہ

ہوئی مدت مدینے حاضری کی
کھلا ہے اب بھی یادوں کا دریچہ

بہ رنگِ اجتہاد، اجماع ِ اُمت
یہی ہے فِکر تازہ کا دریچہ

مجھے سرشار رکھتا ہے یہ گھر میں
مدینے کی طرف رکھا دریچہ

سخن کو معتبر رکھتا ہے ہر دم
یہ رنگِ نعت میں ڈوبا دریچہ

جنگی جرائم اسلام اور بین الاقوامی قانون کے تناظر میں

In ancient and modern era wars, such war crimes are committed which are against humanity and peace. The war crimes committed were only for power pelf  and pomp. The  continuation of those war crimes is still present in modern time wars. Islam has introduced a very civilized, meaningful and judicious  way for war fare  against enemy and also eradicated all kind of  war crimes.

The Great Game in Kipling’S Works

This dissertation, The Great Game in Kipling’s Works, argues that Rudyard Kipling thematically treats the Great Game in his masterpiece novel Kim (1901), in an attempt to romanticize British Imperial adventure in Central Asia. This term symbolizes Kipling’s philosophy, reinforced by a Eurocentric perspective of other races and cultures. The framework of this research situates Kipling’s political narrative and diction in his major works that loudly speak of an Imperial world-view. The Great Game of the 19th Century, which the Russians call Tournament of Shadows or Bolshya Igra, is about the diplomatic and intelligence warfare between England and Russia, for supremacy in Central Asia. During the period, daring men, spies and intelligence gatherers, crossed borders, at the risk of their own lives to help win the Game for their respective Empires. The tussle continued for almost a century, culminating in the 1907 Anglo-Russian Convention, as a result of which Afghanistan emerged as a buffer state between the two contending nations. Arthur Connolly (1907-1984) of the Bengal Light Cavalry is credited to have coined the term, Great Game, while Rudyard Kipling (1865-1937), the first Englishman and the youngest recipient of the Noble Prize for literature (1907), fictionalized it in his masterpiece novel, Kim. Though novelists, John Masters in The Lotus and the Wind and George Fraser in Flashman and the Great Game have also treated this theme, yet Kipling mainstreamed the power play. This dissertation consists of five chapters, an Introduction and a Conclusion, discussing how Kipling viewed the Great Game, attaching greatness and glory to it. Chapter One, Kim’s Game, explores the origin of the term, Great Game and its evolution to our times, in such euphuisms as the New Great Game or the New Energy Game, with specific focus on Kipling most celebrated work, Kim (1901). This part of the thesis discusses the novel in detail, giving its many aspects and summarizing how its main protagonist, ii Kimball’ O’ Hara, Kim for short, thwarts Russian designs to encroach on India, the Jewel in the English Crown. Other themes include Buddhism, the Indian social, cultural and religious spectacle, stereotyping and Russophobia, yet it is the very idea of the Great Game that dominates the story of Kim. This chapter also includes discussion on different Frontier Policies of the Raj, and a reference to the so-called Gilgit-Game. An important section covers information about more than a dozen local spies or what this work refers to as local Great Gamers, Gulab Khan and others, operating from Peshawar, Kashmir and other parts of British India. Like their British masters, namely Connolly, Stoddart, Burns, Pottinger, Younghusband and others, they had to face extreme circumstances in their endeavor to bring glory to England. British adventurism in Tibet and most importantly in Afghanistan, particularly the two Anglo-Afghan Wars of 1838, and 1878 respectively, has been dilated upon in detail. Peter Hopkirk’s works have also been reviewed, to highlight Kipling’s perspective on British policy towards Russia, Chapter Two, “Oh East is East”, is about Kipling’s view of the Orient and in this context, his famous poem; The Ballad of the East and West has been appreciated from the standpoint of Oriental studies. The Eurocentric world view held by the writer, explicit in the poems, Recessional-A Victorian Ode, The White Man’s Burden, and Fuzzy-Wuzzy beside the short story, The Enlightenment of Mr. Paget M.P have also been commented upon. Important works by mainstream scholars, particularly Edward Said, on the Orient, racism and cultural diffusion have also been discussed. Chapter Three, Kipling’s ‘Sea of Dreams’, is Kipling specific, focusing on his life and works, including a chronology of his literary career. His encyclopedic work, thematically ranging from Empire to science-fiction, Freemasonry, English history, jingoism, and democracy, has also been reviewed. It has been noted how his view of Empire, at times, overshadows iii his art and even in the children works, like The Jungle Books (1984-1895), a colonial construct is seen at work. Chapter-IV, Politics of Literature, is about Kipling’s politics which he liberally adds to his creative works, more so, his famous Ballads (1892). As a journalist, with the Civil and Military Gazette (CMG), The Pioneer and later on, with The Friend, Kipling passionately wrote to exalt the British Empire and insisted on bringing civilization to the world. Other works, including The Man Who Would Be King (1888), have been referred, highlighting the literature of Colonialism that Kipling so enthusiastically produced. Literature of Empire has been reviewed for comparative analysis, and Kipling’s own works have been critically assessed, to highlight the political content of his works. Chapter-V, Light, Twilight, is about Kipling’s disillusionment and fading of his vision of Imperialism and Empire-building. The bitterness of his later life is summed up through an assessment of his major works. The center point of this chapter establishes that Kipling’s light of Empire turned out to be the twilight of his dream. The review explores that his vision of empire faded, and doubt and cynicism defined the later life of Rudyard Kipling, with the passing of Empire. This research concludes that Kipling’s treatment of the Great Game notifies politics of literature and its imperial narrative is an attempt to apologies for British Empire. Imperialism is his ultimate source of inspiration. His major works contain a Eurocentric world view and an Orientalized perspective with a biased representation. His literature replicates a constructed reality; an idealized colonial order which faded with the passing of colonialism. His later works is defined by disillusionment and despondency with empire-building, becoming twilight of his vision.