Desempeño en la Detección de Nódulos Mamarios del Examen Clínico de Seno Realizado por Examinadoras Invidentes Comparado con Ultrasonido
Olave Asprilla, Luis Alberto
Botero Henao, Diego Fernando
Fernández De Córdoba Florez, Yiset Adriana
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Resumen. Introducción: Clinical examination of the breast is a simple method to detect nodules, which is useful to determine its nature, of low cost, non-invasive and of great value as a diagnostic tool when necessary. Traditionally, clinical examination is carried out by trained health personnel with a sensitivity of 54% and a specificity of 94%; it is unknown its usefulness compared to mammography, since the physical examination in patients without previous screening has not been evaluated. Objetivo: to determine the performance of the clinical examination of tactile auxiliary examiners for detecting mammary nodules, compared with the ultra-sonography findings in the detection of mammary nodules. Métodos: a validation study of diagnostic tests was carried out with a random sample of 325 women from the San Juan de Dios Hospital, aged between 18 and 70 years, during a period of 2 months. Resultados: The sensitivity was 64.8% (95% CI 57.5-71); specificity, 45.6% (95% CI 37.8-53.6); positive predictive value, 58.5% (95% CI 51.4-65.1); negative predictive value, 52.3% (95% CI 43.8-60.7). Proportion of false positives, 54.4% (95% CI 46.4-62.2); proportion of false negatives, 35.2% (95% CI 28.6-42.5). Conclusión: The study showed that the clinical examination of the breast by trained personnel with visual impairment is a diagnostic test sensitive to the detection of mammary nodules; but it has little specificity. In addition, it is a complement to screening for mammary pathology, even though it does not replace the medical examination nor the screening tests recommended by the clinical practice guidelines.
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