Abstract:

Objective

To investigate the diagnostic performance of ultrasonography (US) and mammography (MAM) for breast lesions.

Methods

The US and MAM imaging data of 1 083 patients with breast diseases in Shunyi Health Care Hospital for Women and Children in 2007-2014 were retrospectively analyzed. The patients were divided into 4 groups: ＜40 years,40-49 years,50-59 years, ≥60 years, or the patients were divided into 4 groups of Ⅰ-Ⅳbased on breast density. Pathological diagnosis of the lesions was set as the gold standard, and the BI-RADS grades 4 and 5 of US and MAM were regarded as positive results.ROC curve analysis was used to evaluate the diagnosis performances of US and MAM. Kappa test was used to evaluate the consistency of US, MAM and combined diagnosis of both.

Results

All patients had definite pathological diagnosis, including 386 cases of breast cancer and 697 cases of benign diseases. Among 386 cases of breast cancer, the sensitivity and specificity of US alone for diagnosis of breast cancer were 93.0%(359/386) and 87.8% (612/697), and the sensitivity and specificity of MAM alone were 76.2%(294/386) and 92.4% (644/697), and the sensitivity and specificity of combined diagnosis were 95.1%(367/386) and 82.6% (576/697). With pathological diagnosis as the gold standard, the Kappa values of US and MAM in consistency test were 0.782 and 0.701 respectively, and the Kappa value of combined diagnosis was 0.734 (all P＜0.001). The areas under ROC curves of US and MAM for diagnosis of breast lesions were 0.904 (95%CI:0.885-0.921, P＜0.001) and 0.843 (95%CI: 0.820-0.864, P＜0.001), respectively.US was significantly superior to MAM (Z=5.930,P＜0.001). In 4 age groups, US had a better diagnostic value compared with MAM (Z = 2.549, 5.332, 3.584, 2.031, all P＜0.050). US and MAM had an equivalent diagnostic value for lesions of grade Ⅱbreast density (Z=0.178, P=0.859), while US had an significantly better diagnostic value for lesions of gradesⅠ, Ⅲand Ⅳbreast density (Z=2.129, 5.847,3.437, all P＜0.050).

Conclusions

Both US and MAM show a good diagnostic value for breast lesions,while US is more effective than MAM. MAM combined with US is recommended for women with dense breast in clinical practice, in order to improve the detection rate of breast lesions.

Key words: Breast diseases; Ultrasonography; Mammography; Diagnosis