Alberto Stefano Tagliafico1, Bianca Bignotti2, Federica Rossi3, Alessio Signori4, Maria Pia Sormani4, Francesca Valdora5, Massimo Calabrese6, Nehmat Houssami7. 1. Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Via L.B. Alberti, 16132 Genoa, Italy. Electronic address: alberto.tagliafico@unige.it. 2. Radiology Department, Department of Health Sciences, University of Genoa, Via Pastore, 16132 Genoa, Italy. 3. School of Medicine, University of Genoa, Via Pastore, 16132 Genoa, Italy. 4. Institute of Statistics, Department of Health Sciences, University of Genoa, Via Pastore, 16132 Genoa, Italy. 5. Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Via L.B. Alberti, 16132 Genoa, Italy. 6. Radiology Department, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Largo Rosanna Benzi 10, 16138 Genoa, Italy. 7. School of Public Health, Sydney Medical School, University of Sydney, 2006, Australia.
Abstract
PURPOSE: To estimate sensitivity and specificity of CESM for breast cancer diagnosis. METHODS: Systematic review and meta-analysis of the accuracy of CESM in finding breast cancer in highly selected women. We estimated summary receiver operating characteristic curves, sensitivity and specificity according to quality criteria with QUADAS-2. RESULTS: Six hundred four studies were retrieved, 8 of these reporting on 920 patients with 994 lesions, were eligible for inclusion. Estimated sensitivity from all studies was: 0.98 (95% CI: 0.96-1.00). Specificity was estimated from six studies reporting raw data: 0.58 (95% CI: 0.38-0.77). The majority of studies were scored as at high risk of bias due to the very selected populations. CONCLUSION: CESM has a high sensitivity but very low specificity. The source studies were based on highly selected case series and prone to selection bias. High-quality studies are required to assess the accuracy of CESM in unselected cases.
PURPOSE: To estimate sensitivity and specificity of CESM for breast cancer diagnosis. METHODS: Systematic review and meta-analysis of the accuracy of CESM in finding breast cancer in highly selected women. We estimated summary receiver operating characteristic curves, sensitivity and specificity according to quality criteria with QUADAS-2. RESULTS: Six hundred four studies were retrieved, 8 of these reporting on 920 patients with 994 lesions, were eligible for inclusion. Estimated sensitivity from all studies was: 0.98 (95% CI: 0.96-1.00). Specificity was estimated from six studies reporting raw data: 0.58 (95% CI: 0.38-0.77). The majority of studies were scored as at high risk of bias due to the very selected populations. CONCLUSION: CESM has a high sensitivity but very low specificity. The source studies were based on highly selected case series and prone to selection bias. High-quality studies are required to assess the accuracy of CESM in unselected cases.
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