Top

European Journal of Medical Research

Published in:

Open Access 01-12-2015 | Research

Limitations of mammography in the diagnosis of breast diseases compared with ultrasonography: a single-center retrospective analysis of 274 cases

Authors: Hong Zhao, Liwei Zou, Xiaoping Geng, Suisheng Zheng

Published in: European Journal of Medical Research | Issue 1/2015

Abstract

Background

The aim of this study is to compare X-ray mammography (MG) and ultrasonography (US) in the diagnosis of breast diseases in Chinese women.

Methods

We retrospectively analyzed X-ray mammograms of 274 patients with US and surgical/pathological results of breast diseases diagnosed at The Second Affiliated Hospital of Anhui Medical University (Hefei, China) between March 2011 and November 2014. The MG and US data were compared to surgical records using the results from post-surgical pathological examinations as the gold standard.

Results

The overall sensitivity, specificity, accuracy, false-positive, false-negative, positive predictive value, and negative predictive value for the detection of breast cancer were 88.5%, 57.9%, 73.7%, 42.1%, 11.5%, 69.2%, and 82.5%, respectively, for MG and 95.9%, 66.7%, 81.8%, 33.3%, 4.1%, 75.5%, and 93.8%, respectively, for US. Of the 274 cases, lesion size by MG agreed with surgery in 133 (48.5%) patients compared with 216 (78.8%) by US (P < 0.01). Lesion location by MG agreed with surgery in 146 (53.3%) patients compared with 257 (93.8%) by US (P < 0.01). These values were then stratified according to age, menstrual status, breast density, and breast volume, and the agreement rates of MG with surgery were lower than that of US (all P < 0.01), except when the lesion size was >5 cm (P > 0.05).

Conclusions

US was better than MG in the preoperative evaluation of breast diseases of Chinese women. These results suggest that US could be more useful for detecting breast lesions in China, especially for younger women with dense breasts.

Brem RF, Rapelyea JA, Zisman G, Hoffmeister JW, Desimio MP. Evaluation of breast cancer with a computer-aided detection system by mammographic appearance and histopathology. Cancer. 2005;104:931–5.CrossRefPubMed

Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med. 2007;356:227–36.CrossRefPubMed

Maskarinec G, Meng L, Ursin G. Ethnic differences in mammographic densities. Int J Epidemiol. 2001;30:959–65.CrossRefPubMed

Pisano ED, Gatsonis C, Hendrick E, Yaffe M, Baum JK, Acharyya S, et al. Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med. 2005;353:1773–83.CrossRefPubMed

Shao H, Li B, Zhang X, Xiong Z, Liu Y, Tang G. Comparison of the diagnostic efficiency for breast cancer in Chinese women using mammography, ultrasound, MRI, and different combinations of these imaging modalities. J Xray Sci Technol. 2013;21:283–92.PubMed

Bassett LW, Berg WA. Breast Imaging Reporting and Data System, BI-RADS: mammography. 4th ed. Reston: American College of Radiology; 2003.

Kalbhen CL, Kezdi-Rogus PC. Changes in breast compressibility with age: implications for stereotactic biopsy. Can Assoc Radiol J. 1999;50:93–7.PubMed

Kayar R, Civelek S, Cobanoglu M, Gungor O, Catal H, Emiroglu M. Five methods of breast volume measurement: a comparative study of measurements of specimen volume in 30 mastectomy cases. Breast Cancer (Auckl). 2011;5:43–52.

Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study: update on breast cancer mortality. J Natl Cancer Inst Monogr. 1997;1997:37–41.

10.

Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348:g366.CrossRefPubMedCentralPubMed

11.

Roberts MM, Alexander FE, Anderson TJ, Chetty U, Donnan PT, Forrest P, et al. Edinburgh trial of screening for breast cancer: mortality at seven years. Lancet. 1990;335:241–6.CrossRefPubMed

12.

Liu J, Liu PF, Li JN, Qing C, Ji Y, Hao XS, et al. Analysis of mammographic breast density in a group of screening chinese women and breast cancer patients. Asian Pac J Cancer Prev. 2014;15:6411–4.CrossRefPubMed

13.

Kerlikowske K, Grady D, Barclay J, Sickles EA, Ernster V. Effect of age, breast density, and family history on the sensitivity of first screening mammography. JAMA. 1996;276:33–8.CrossRefPubMed

14.

Gierach GL, Ichikawa L, Kerlikowske K, Brinton LA, Farhat GN, Vacek PM, et al. Relationship between mammographic density and breast cancer death in the Breast Cancer Surveillance Consortium. J Natl Cancer Inst. 2012;104:1218–27.CrossRefPubMedCentralPubMed

15.

Suzuki A, Ishida T, Ohuchi N. Controversies in breast cancer screening for women aged 40–49 years. Jpn J Clin Oncol. 2014;44:613–8.CrossRefPubMed

16.

Wang FL, Chen F, Yin H, Xu N, Wu XX, Ma JJ, et al. Effects of age, breast density and volume on breast cancer diagnosis: a retrospective comparison of sensitivity of mammography and ultrasonography in China’s rural areas. Asian Pac J Cancer Prev. 2013;14:2277–82.CrossRefPubMed

17.

Hooley RJ, Greenberg KL, Stackhouse RM, Geisel JL, Butler RS, Philpotts LE. Screening US in patients with mammographically dense breasts: initial experience with Connecticut Public Act 09-41. Radiology. 2012;265:59–69.CrossRefPubMed

18.

Weigert J, Steenbergen S. The connecticut experiment: the role of ultrasound in the screening of women with dense breasts. Breast J. 2012;18:517–22.CrossRefPubMed

19.

Tsai HW, Twu NF, Ko CC, Yen MS, Yang MJ, Chao KC, et al. Compliance with screening mammography and breast sonography of young Asian women. Eur J Obstet Gynecol Reprod Biol. 2011;157:89–93.CrossRefPubMed

20.

Zanello PA, Robim AF, Oliveira TM, Elias Junior J, Andrade JM, Monteiro CR, et al. Breast ultrasound diagnostic performance and outcomes for mass lesions using Breast Imaging Reporting and Data System category 0 mammogram. Clinics (Sao Paulo). 2011;66:443–8.CrossRef

21.

Cherel P, Hagay C, Benaim B, De Maulmont C, Engerand S, Langer A, et al. Mammographic evaluation of dense breasts: techniques and limits. J Radiol. 2008;89:1156–68.CrossRefPubMed

22.

Devolli-Disha E, Manxhuka-Kerliu S, Ymeri H, Kutllovci A. Comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density. Bosn J Basic Med Sci. 2009;9:131–6.PubMed

23.

Liberman L, Menell JH. Breast imaging reporting and data system (BI-RADS). Radiol Clin North Am. 2002;40:409–30.CrossRefPubMed

24.

Crystal P, Strano SD, Shcharynski S, Koretz MJ. Using sonography to screen women with mammographically dense breasts. AJR Am J Roentgenol. 2003;181:177–82.CrossRefPubMed

25.

Zhi H, Ou B, Luo BM, Feng X, Wen YL, Yang HY. Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions. J Ultrasound Med. 2007;26:807–15.PubMed

26.

Jiang H, Bu X, Sun Y, Xu K, Zheng X. Ultrasonography is more accurate than mammography in preoperative evaluations of palpable breast tumors in Chinese women. Breast J. 2013;19:677–9.CrossRefPubMed

27.

Leong LC, Gogna A, Pant R, Ng FC, Sim LS. Supplementary breast ultrasound screening in Asian women with negative but dense mammograms-a pilot study. Ann Acad Med Singapore. 2012;41:432–9.PubMed

28.

Masroor I, Ahmed MN, Pasha S. To evaluate the role of sonography as an adjunct to mammography in women with dense breasts. J Pak Med Assoc. 2009;59:298–301.PubMed

29.

Orel SG. High-resolution MR, imaging for the detection, diagnosis, and staging of breast cancer. Radiographics. 1998;18:903–12.CrossRefPubMed

30.

Kelcz F, Santyr G. Gadolinium-enhanced breast MRI. Crit Rev Diagn Imaging. 1995;36:287–338.PubMed

31.

Van Goethem M, Tjalma W, Schelfout K, Verslegers I, Biltjes I, Parizel P. Magnetic resonance imaging in breast cancer. Eur J Surg Oncol. 2006;32:901–10.CrossRefPubMed

32.

Lehman CD, Isaacs C, Schnall MD, Pisano ED, Ascher SM, Weatherall PT, et al. Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study. Radiology. 2007;244:381–8.CrossRefPubMed

33.

Bazzocchi M, Zuiani C, Panizza P, Del Frate C, Soldano F, Isola M, et al. Contrast-enhanced breast MRI in patients with suspicious microcalcifications on mammography: results of a multicenter trial. AJR Am J Roentgenol. 2006;186:1723–32.CrossRefPubMed

34.

Gur D. Tomosynthesis-based imaging of the breast. Acad Radiol. 2011;18:1203–4.CrossRefPubMed

35.

Zuley ML, Bandos AI, Ganott MA, Sumkin JH, Kelly AE, Catullo VJ, et al. Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology. 2013;266:89–95.CrossRefPubMedCentralPubMed

36.

Chae EY, Kim HH, Cha JH, Shin HJ, Kim H. Evaluation of screening whole-breast sonography as a supplemental tool in conjunction with mammography in women with dense breasts. J Ultrasound Med. 2013;32:1573–8.CrossRefPubMed

37.

Fletcher SW, Black W, Harris R, Rimer BK, Shapiro S. Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst. 1993;85:1644–56.CrossRefPubMed

Title: Limitations of mammography in the diagnosis of breast diseases compared with ultrasonography: a single-center retrospective analysis of 274 cases
Authors: Hong Zhao
Liwei Zou
Xiaoping Geng
Suisheng Zheng
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: European Journal of Medical Research / Issue 1/2015
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-015-0140-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Limitations of mammography in the diagnosis of breast diseases compared with ultrasonography: a single-center retrospective analysis of 274 cases

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

Case analysis of complete remission of advanced hepatocellular carcinoma achieved with sorafenib

RETRACTED ARTICLE: Meta-analysis of the associations between TNF-α or IL-6 gene polymorphisms and susceptibility to lung cancer

Acute quadriplegia caused by necrotizing myopathy in a renal transplant recipient with severe pneumonia: acute onset and complete recovery

“Different trend” in multiple primary lung cancer and intrapulmonary metastasis

The molecular fingerprint of lung inflammation after blunt chest trauma

Retraction Note: Integrated gene network analysis and text mining revealing PIK3R1 regulated by miR-127 in human bladder cancer