 Good morning everyone, my paper presentation topic is ultrasonography and evaluation of breast lesions staged by Byrads in correlation with FNSA and dystopathology. My co-authors are B. Paneel Kumar, Professor MDRD and Dr. Pradip Kumar, Professor MDRD. I'm introduction sonography has become a standard breast imaging procedure during the last 15 years because of technological advances such as use of all high frequency transducers up to 13 megahertz and color and power docker imaging. My ambition objectives include evaluation of breast lesions using ultrasonography and classify them using ultrasound Byrads categorization to evaluate sensitivity, specificity, post-operative value, interpretive value and accuracy sonography in differentiating malignant form benign lesions to determine the most accurate sonography feature in differentiating malignant from benign lesions to correlate ultrasound features of breast lesions with FNSA and dystopathology. My materials and methods include source of data from Department of Radiology Shantra Medical College Nandiyal and the duration of study is from October 2020 to January 2020 which includes 50 sample size. My sampling criteria include inclusion criteria which is all patients with clinically palpable breast lesions or with suspicious lesions from mammography about 18 years of age are included and follow-up of tissue diagnosis that during the duration of my study in this hospital are included. Coming to exclusion criteria, all patients with inflammatory breast lesions and patients whose sonological examination is inadequate or tissue diagnosis not available are those who lost follow-up. Coming to results analysis, this table shows distribution of patients according to age group. This table shows talentic symptoms. This table shows ultrasonographic findings. This table shows frequency of the shape of index mass lesions on ultrasonography. This table shows frequency of the margins of index lesion on ultrasonography. This table shows frequency of presence or absence of pseudo-capsular index lesions. This table shows frequency of posterior aqua intensity index lesions. This table shows frequency of ecogenity of the index lesions. This table shows frequency of microcalcifications in index lesions. This table shows frequency of flow characterization of index lesions on color Doppler. This table shows frequency of pattern of of aspecialization or index lesion on color Doppler sonography. This table shows frequency of resistive index lesion on color Doppler sonography. This table shows frequency of Byrads' category of index lesions on ultrasound. This table shows calculation of p-value for ultrasound features. This table shows calculation of significance for Byrads. And this table shows results of comparison of Byrads with BioC. And this table shows results of conversion of Byrads with FNIC. This table shows comparison of ultrasound features with FNIC and BioC. This table shows histopathology for the final diagnosis of the index lesion. And this table shows histopathology and FNIC for the type of carcinoma in index lesions. This table shows comparison of ultrasound classification with the pathological findings in 50 breast lesions to detect malignant lesions. All 50 patients who underwent ultrasound examination were in age group of 90 to 55 years, a palpable breast lump was most common for them to complete. Some patients had more than one complaint. Focal mass was the most common finding on ultrasound. Associated axillary lipids were seen in eight patients. Four of which were seen in malignant lesions. All of the malignant lesions were hypoechoic. Majority of them showed irregular shape, its secreted margins, and distal acoustic attenuation 63.6%. Majority of the malignant lesions showed dilapidated and oval shape. Echogenic pseudocapsules surrounding the lesion were seen in 25% of cases. Other benign sonographic features included hypogenicity and smooth margins in 75% cases. Other sonographic color signal were seen in 90.1% of malignant and 28.6% benign lesions. Majority of them malignant lesions showed penetrating pattern of vascularization. Spectral Doppler analysis of breast lesions shows RI greater than 0.99 in 90% of malignant lesions and RI less than 0.99 in 87.5% of benign lesions. 11 malignant lesions were characterized as bi-rats five and 13 lesions as bi-rats for ultrasound. Most of the primary tumors were infiltrative ductal carcinoma on histopathology except two of them were medullary carcinoma on malignant fillouts on musinus secreting carcinoma. It is found that ultrasound is insensitive for the detection of index tumors. This is the case of medullary carcinoma. This ultrasoundogram shows large hypochloric mass lesion with areas of specks of calcification and the actual tail of breast. Here we can see in the histopathological picture the synthecial pattern of underplastic tumor cells with surrounding lymphoplasmostatic infiltrates. This is the case of fibroid normal. This sonogram shows hypoequilation with a smooth margin with few specks of calcification. The histopathological picture shows intra-analytical imagination of stromal connective tissue with increased stromal component. This is the case of intracarcinoma. This ultrasoundogram shows hypoequilation in retroilliar region with angular margins. This lesion shows evidence of peripheral basclarity. This histopathological picture demonstrates cellular clusters of ductilectile cells with gliomorphic hypochromotic UVA, which is in a high-grade intracarcinoma. This is the case of fibroid normal. On this sonogram, we can see subellic circumscribed mass lesion, which is heterogeneously hypoic and has microablosions with specks of calcifications. This histopathological picture shows increased evenly distributed glandular and stromal components. This is the case of invasive ductile carcinoma. Here we can see mass lesion with irregular margins and area of cystic lesion. Central and eccentric intracystics of tissues are noted. This sonogram demonstrates evidence of peripheral basclarity with low resistance flow. This histopathological picture shows gliomorphic hypochromatic nuclei within highly cellular ductilectile cells seen in the middle stromal tissue, seen in invasive ductile carcinoma. This is the case of invasive ductile carcinoma. The ultrasoundogram shows the different hypoic mass lesion with the microcalcifications and irregular margins is seen in breast. This histopathological picture shows gliomorphic hypochromatic nuclei with high cellular ductilectile cells seen in the stromal tissue, arranged in sheets and cords. This is a picture of invasive ductile carcinoma. This sonogram shows hypochromatic mass lesion with the angular margins. And also we can see large axillary lymphenopathy in the breast. This picture shows highly cellular ductilectile cells with hypochromatic nuclei seen in the stromal tissue, arranged in sheets and cords. This is the case of medial ductile carcinoma showing hypochromatic collision with penetrating artery. Restive index was seen more than 0.99. This histopathological picture shows large tumor cells in a syncytine satchel and are sharply separated from the surrounding stroma which is heavily infiltrated by lymphocytes and blast muscles. This is the case of pilots tumor. This ultrasoundogram shows large-cancelated, smooth-marginated hypochromatic mass lesion with multiple septations in the breast. This histopathological picture shows nodular structure with the prominent stromal proliferation in peridactal regions. This is the case of misnosticidic carcinoma. Here we can see fairly well-defined hypochromatic lesion in the right inner quadrant with the lopulated margin on the middle aspect of the lesion. This microscopic picture shows evidence of large glandar cells with the extracellular holes of musin surrounding aggregates of low-grade cancer cells. Coming to discussion, ultrasoundographies use the screening modality for screening of breast lesions. All patients suspected breast lesions should be subjected to ultrasound for initial detection and localization of lesion. There is ultrasound morphological features in the plant. Steady ortidine, overall sensitivity of 90.9% and precipitate of 87.7% and prostitute by the value of 83 and an integrative value of 92% for manual lesions. My study was a sequential screening test in which cases where FNIC positive went in for biopsy. Comparison of ULC with FNIC revealed sensitivity of 80s, 78 and the specificity of 77. And comparison of ultrasound with histopathological examination revealed sensitivity of 72 and specificity of 100%. To conclude, ultrasound is sensitive major modulate for the evaluation of the suspicious breast lesions. Ultrasonography helps to evaluate the disease morphology and extend better. It is recommended that ultrasonography be the initial screening tool in patients suspected breast lesions followed by higher imaging modalities like contrast MRI for further calculations if indicated. This protocol helps the operating surgeon to give the maximum information about the lesion by also providing a roadmap prior to surgery. Having completion, this was a sequential screening test done as a prospective study as a diagnostic efficiency of the ultrasound in clinical and mammographically detected breast lesions to differentiate breast from malignant lesions and to determine the extent of primary breast gastroenoma. All 50 patients underwent ultrasonography followed by histopathology or FNIC for final analysis. Ultrason was performed using high frequency probe that is shown in some periods. IU-22 equipment, focal mass for the most common ultrasonography finding associated Alexandria lymph nodes were seen in 8 patients. All of the malignetitions majority of them show irregular shape is circulated margin and crystal acoustic termination. Majority of benign lesions show laminated margin and oval shape echogenic pseudo-capsule surrounding the lesion was seen in 25% of cases. Other sonography features include hypo-equivalent chance, smooth margins in 75% of cases. On the galler-dopper sonography galler-dopper sclerotic serine 90% of malignet 28% of benign lesions. Majority of malignetion showed penetrating pattern of acetyluridation. Factoral Doppler analysis of breast lesions showed RI greater than 0.99 and in 90% of malignetions less than 0.99, 87.5 of benign lesions. Based on Bayreth's classification according to American College of Radiology breast lesions are characterized as benign, probably benign, probably malignet and malignet. 11 malignet lesions were characterized as Bayreth's 5 and 13 lesions as Bayreth's 4 ultrasonography. These are my references. Thank you.