Mammographic, ultrasound and pathological concordance in the diagnosis of breast cancer in Kinshasa

Introduction: Breast cancer remains one of the most common malignancies worldwide and is a leading cause of mortality, including in the Democratic Republic of Congo. Early diagnosis is crucial to improve survival rates and relies on the complementarity between medical imaging and histopathology. This study aimed to assess the diagnostic concordance of breast cancer using mammography and/or ultrasound compared with histopathology in Kinshasa.Methods: A cross-sectional analytical study was conducted from June 2022 to June 2025 across three health facilities in Kinshasa (Ngaliema Clinic, Biamba Marie Mutombo Hospital, and Leboma Cabinet). Medical records of patients who underwent mammography and/or breast ultrasound with available histopathological results were included. Cases without histopathology were excluded. Diagnostic concordance was evaluated using Cohen’s Kappa coefficient (?) and Pearson’s Chi-square test.Results: Among 382 imaging procedures, 274 were ultrasounds (71.7%) and 108 mammographies (28.3%); 74 patients (19.4%) underwent both modalities. A total of 304 patients had biopsy results, forming the study population. Of these, 53% (N=160) had malignant tumors and 47% (N=144) benign lesions. Women represented 99% of cases, with a mean age of 41.6 ±16 years. The main consultation reason was palpable nodules (85.8%). Lesions were evenly distributed between breasts, predominantly in the upper outer quadrant (35.4%). Tumors sized 2-