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Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study.

Authors :
Gao LY
Gu Y
Xu W
Tian JW
Yin LX
Ran HT
Ren WD
Mu YM
Zhang JY
Chang C
Yuan JJ
Kang CS
Deng YB
Wang H
Xie XY
Luo BM
Guo SL
Zhou Q
Xue ES
Zhan WW
Jiao T
Zhou Q
Li J
Zhou P
Huang PT
Xue HY
Zhang CQ
Chen M
Jing XX
Gu Y
Guo JF
Ding HY
Xu JF
Chen W
Liu L
Zhang YH
Wang HQ
Mu ZP
Li JC
Wang HY
Jiang YX
Source :
Journal of Cancer [J Cancer] 2020 Apr 06; Vol. 11 (13), pp. 3903-3909. Date of Electronic Publication: 2020 Apr 06 (Print Publication: 2020).
Publication Year :
2020

Abstract

Objectives : To assess the performance of elastography (ES) and ultrasound (US) in predicting the malignancy of breast lesions and to compare their combined diagnostic value with that of magnetic resonance imaging (MRI). Materials and Methods : The study prospectively enrolled 242 female patients with dense breasts treated in 35 heath care facilities in China between November 2018 and October 2019. Based on conventional US and elastography, radiologists classified the degree of suspicion of breast lesions according to the US Breast Imaging Reporting and Data System (BI-RADS) criteria. The diagnostic value was compared between US BI-RADS and MRI BI-RADS, with pathological results used as the reference standard. Results : The results demonstrated that irregular tumor shape, a nonparallel growth orientation, indistinct margins, angular contours, microcalcifications, color Doppler flow and ES score on US imaging were significantly related to breast cancer in dense breasts (P=0.001; P=0.001; P=0.008; P<0.001; P=0.019; P=0.008; P=0.002, respectively). The sensitivity, specificity, PPV, NPV, accuracy and AUC of US BI-RADS category were 94.7%, 90.7%, 95.8%, 88.0%, 93.4% and 0.93 (95%CI, 0.88-0.97), respectively, while those of MRI BI-RADS category were 98.2%, 57.5%, 84.3%, 83.3%, 86.0% and 0.78 (95%CI, 0.71-0.85), respectively. MRI BI-RADS showed a significantly higher sensitivity than US BI-RADS (98.2% vs 94.7%, P=0.043), whereas US BI-RADS showed significantly higher specificity (90.7% vs 57.5%, P<0.001). US BI-RADS showed better diagnostic efficiency in differentiating nodules in dense breasts than MRI BI-RADS (AUC 0.93 vs 0.78, P<0.001). Conclusion : By combining the use of ES and conventional US, US BI-RADS had better diagnostic efficiency in differentiating nodules in dense breasts than MRI. For the diagnosis of malignant tumors in patients with dense breasts, MRI and US BI-RADS can be used as supplemental diagnostic tools to detect lesions, with US BI-RADS considered the preferred adjunctive resource.<br />Competing Interests: Competing Interests: The authors have declared that no competing interest exists.<br /> (© The author(s).)

Details

Language :
English
ISSN :
1837-9664
Volume :
11
Issue :
13
Database :
MEDLINE
Journal :
Journal of Cancer
Publication Type :
Academic Journal
Accession number :
32328194
Full Text :
https://doi.org/10.7150/jca.43326