To assess the diagnostic efficacy of mammography(MAM)combined with ultrasonography (US) and magnetic resonance imaging (MRI) for breast cancer.

The imaging data (including MAM, US and MRI) of 255 patients(260 breast lesions)with breast diseases in the Fourth Affiliated Hospital of Hebei Medical University from April 2015 to December 2016 were analyzed retrospectively. Pathological diagnosis of the lesions was set as the gold standard. The diagnostic results of MAM, US and MRI are classified according to BI-RADS and the lesions of BI-RADS grades 4 and 5 were regarded positive. The receiver operating characteristic (ROC) curve was used to evaluate the diagnosis performances of the two methods. Kappa test was used to evaluate the consistency of the two methods with the pathological results.

The sensitivity, specificity and accuracy of MAM combined with US for breast cancer diagnosis were 98.6%(204/207), 77.4%(41/53) and 94.2%(245/260), respectively. The sensitivity, specificity and accuracy of MRI were 98.1%(203/207), 66.0%(35/53) and 91.5%(238/260), respectively. With the pathological diagnosis as the gold standard, the Kappa value of MAM combined with US in consistency test was 0.810 (P<0.001), while the Kappa value of MRI was 0.711(P<0.001). The areas under ROC curves of MAM combined with US and MRI for the diagnosis of breast lesions were 0.902(95% CI: 0.843-0.961, P<0.001)and 0.893(95% CI: 0.842-0.945, P<0.001), indicating no significant difference (Z=0.050, P>0.050).

MAM combined with US and MRI both have high diagnostic accuracy for breast cancer, with equivalent diagnostic value. MAM combined with US is the first choice for breast cancer patients because of its simple operation and low cost, but the role of MRI in preoperative evaluation of breast cancer is irreplaceable.