Wolfgang Buchberger1, Sabine Geiger-Gritsch2, Rudolf Knapp3, Kurt Gautsch4, Willi Oberaigner5. 1. Medical Department, Tirol Kliniken Ltd., Anichstr. 35, 6020 Innsbruck, Austria; Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall i.T., Austria. 2. Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall i.T., Austria; Department of Clinical Epidemiology of Tirol Kliniken Ltd., Anichstr. 35, 6020 Innsbruck, Austria. 3. Department of Radiology, Kufstein County Hospital, Endachstr. 27, 6330 Kufstein, Austria. 4. Department of Radiology, Innsbruck Medical University, Anichstr. 35, 6020 Innsbruck, Austria. 5. Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall i.T., Austria; Department of Clinical Epidemiology of Tirol Kliniken Ltd., Anichstr. 35, 6020 Innsbruck, Austria. Electronic address: Wilhelm.oberaigner@umit.at.
Abstract
OBJECTIVES: To compare the performance of screening with mammography combined with ultrasound versus mammography alone in women at average risk for breast cancer. METHODS: 66,680 women underwent physician-performed ultrasound as an adjunct to screening mammography. Histological results and follow-up at one year were used as reference standard for sensitivity. Main outcome measures were cancer detection rate, sensitivity, recall rate, biopsy rate, and positive predictive value of biopsy for combined screening with mammography plus ultrasound versus mammography alone. RESULTS: The overall sensitivity of mammography only was 61.5% in women with dense breasts and 86.6% in women with non-dense breasts. The sensitivity of mammography plus ultrasound combined was 81.3% in women with dense breasts and 95.0% in women with non-dense breasts. Adjunctive ultrasound increased the recall rate from 10.5 to 16.5 per 1000 women screened, and increased the biopsy rate from 6.3 to 9.3 per 1000 women screened. The positive predictive value of biopsy was 55.5% (95% CI 50.6%-60.3%) for mammography alone and 43.3 (95% CI 39.4%-47.3%) for combined mammography plus ultrasound. CONCLUSIONS: Supplemental ultrasound improves cancer detection in screening of women at average risk for breast cancer. Recall rates and biopsy rates can be kept within acceptable limits.
OBJECTIVES: To compare the performance of screening with mammography combined with ultrasound versus mammography alone in women at average risk for breast cancer. METHODS: 66,680 women underwent physician-performed ultrasound as an adjunct to screening mammography. Histological results and follow-up at one year were used as reference standard for sensitivity. Main outcome measures were cancer detection rate, sensitivity, recall rate, biopsy rate, and positive predictive value of biopsy for combined screening with mammography plus ultrasound versus mammography alone. RESULTS: The overall sensitivity of mammography only was 61.5% in women with dense breasts and 86.6% in women with non-dense breasts. The sensitivity of mammography plus ultrasound combined was 81.3% in women with dense breasts and 95.0% in women with non-dense breasts. Adjunctive ultrasound increased the recall rate from 10.5 to 16.5 per 1000 women screened, and increased the biopsy rate from 6.3 to 9.3 per 1000 women screened. The positive predictive value of biopsy was 55.5% (95% CI 50.6%-60.3%) for mammography alone and 43.3 (95% CI 39.4%-47.3%) for combined mammography plus ultrasound. CONCLUSIONS: Supplemental ultrasound improves cancer detection in screening of women at average risk for breast cancer. Recall rates and biopsy rates can be kept within acceptable limits.
Authors: Janie M Lee; Robert F Arao; Brian L Sprague; Karla Kerlikowske; Constance D Lehman; Robert A Smith; Louise M Henderson; Garth H Rauscher; Diana L Miglioretti Journal: JAMA Intern Med Date: 2019-05-01 Impact factor: 21.873
Authors: Fernando Ocasio-Villa; Luisa Morales-Torres; Norma Velez-Medina; Luis A Cubano; Juan C Orengo; Edu B Suarez Martinez Journal: Front Med (Lausanne) Date: 2022-02-10