Takanori Watanabe1, Takuhiro Yamaguchi2, Eriko Tohno3, Hiroko Tsunoda4, Setsuko Kaoku5, Kanako Ban6, Ryoji Watanabe7, Takeshi Umemoto8, Koichi Hirokaga9, Toshikazu Ito10. 1. Department of Breast Surgery, National Hospital Organization Sendai Medical Center, 2-11-12 Miyaginohara, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. tak.mac@mac.com. 2. Division of Biostatistics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. 3. Tsukuba International Breast Clinic, 2F Tsukuba CITYIA Bldg., 2-8-8 Azuma, Tsukuba, Ibaraki, 305-0031, Japan. 4. Department of Radiology Diagnostic Breast Imaging, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. 5. Department of Ultrasonics, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan. 6. Department of Cancer Detection and Diagnosis, Tokyo Health Service Association, 1-2 Ichigaya-sadohara-cho, Shinjuku-ku, Tokyo, 162-8402, Japan. 7. Department of Breast Center, Itoshima Medical Association Hospital, 532-1 Urashi, Itoshima, Fukuoka, 819-1112, Japan. 8. Department of Senology, Moriya Keiyu Hospital, 980-1 Tatsuzawa, Moriya, Ibaraki, 302-0118, Japan. 9. Department of Breast Surgery, Hyogo Cancer Center, 13-70 Kitaoji, Akashi, Hyogo, 673-8558, Japan. 10. Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
Abstract
PURPOSE: Breast ultrasound has been widely used as an essential examination for diagnosing breast cancer. However, standardized diagnostic criteria are as yet lacking. This study aimed to develop a simple diagnostic flowchart for beginners learning breast ultrasonography. The diagnostic flowchart was developed based on the recall criteria widely used in Japan. METHODS: We conducted a multicenter study to examine recall criteria usefulness in the diagnostic phase of breast disease. Women with ultrasound-visible breast masses who underwent B-mode breast ultrasound examination were recruited from 22 hospitals in Japan between September 2009 and January 2010. B-mode images were evaluated by members of the centralized image interpretation committee. We developed the new diagnostic flowchart based on the results. The usefulness of the diagnostic flowchart was assessed by employing datasets from the current study and another study which we conducted (BC-04 study). RESULTS: We evaluated 1045 solid masses (malignant: 495, benign: 550). Multivariate analysis showed that shape, margin, echogenic halo, interruption of the mammary gland interface, and depth width ratio were significant findings for distinguishing between benign and malignant masses. We modified the recall criteria and developed our novel diagnostic flowchart using these findings. The sensitivity and specificity of the new flowchart (current study: 0.97, 0.45; BC-04 study dataset: 0.95, 0.45) were similar to those of experts (current study: 0.96, 0.54; BC-04 study dataset: 0.98, 0.38). CONCLUSION: We developed a simple diagnostic flowchart for breast ultrasound. This flowchart is anticipated to be applicable to educating beginners learning breast ultrasound.
PURPOSE: Breast ultrasound has been widely used as an essential examination for diagnosing breast cancer. However, standardized diagnostic criteria are as yet lacking. This study aimed to develop a simple diagnostic flowchart for beginners learning breast ultrasonography. The diagnostic flowchart was developed based on the recall criteria widely used in Japan. METHODS: We conducted a multicenter study to examine recall criteria usefulness in the diagnostic phase of breast disease. Women with ultrasound-visible breast masses who underwent B-mode breast ultrasound examination were recruited from 22 hospitals in Japan between September 2009 and January 2010. B-mode images were evaluated by members of the centralized image interpretation committee. We developed the new diagnostic flowchart based on the results. The usefulness of the diagnostic flowchart was assessed by employing datasets from the current study and another study which we conducted (BC-04 study). RESULTS: We evaluated 1045 solid masses (malignant: 495, benign: 550). Multivariate analysis showed that shape, margin, echogenic halo, interruption of the mammary gland interface, and depth width ratio were significant findings for distinguishing between benign and malignant masses. We modified the recall criteria and developed our novel diagnostic flowchart using these findings. The sensitivity and specificity of the new flowchart (current study: 0.97, 0.45; BC-04 study dataset: 0.95, 0.45) were similar to those of experts (current study: 0.96, 0.54; BC-04 study dataset: 0.98, 0.38). CONCLUSION: We developed a simple diagnostic flowchart for breast ultrasound. This flowchart is anticipated to be applicable to educating beginners learning breast ultrasound.
Entities:
Keywords:
Breast cancer; Breast ultrasound; Diagnostic criteria; Multicenter study; Multivariate analysis
Authors: Ehsan Samei; Aldo Badano; Dev Chakraborty; Ken Compton; Craig Cornelius; Kevin Corrigan; Michael J Flynn; Bradley Hemminger; Nick Hangiandreou; Jeffrey Johnson; Donna M Moxley-Stevens; William Pavlicek; Hans Roehrig; Lois Rutz; Jeffrey Shepard; Robert A Uzenoff; Jihong Wang; Charles E Willis Journal: Med Phys Date: 2005-04 Impact factor: 4.071