Skaane P, Sager E M, Olsen J B, Abdelnoor M, Berger A, Wolff P A, Kullmann G
Department of Radiology, Ullevaal University Hospital, Oslo, Norway.
Acta Radiol. 1999 Mar;40(2):163-8. doi: 10.3109/02841859909177732.
To analyze the diagnostic accuracy of mammography, ultrasonography (US), and both methods combined in evaluation of palpable noncalcified breast tumors.
Mammograms and sonograms of 200 patients with palpable noncalcified breast masses were retrospectively analyzed independently by four experienced radiologists in 3 sessions: Mammography or US interpretations in the first two and combined reading in the last session. Nonneoplastic abnormalities and mammographically obvious cancers were excluded. Receiver operating characteristic (ROC) analyses were performed for 115 (60 benign and 55 malignant) tumors and subgroups according to tissue density and tumor size. A single ROC curve for each diagnostic test was obtained by pooling the individual ratings. The area under the ROC curve was used as a measure of diagnostic performance.
US revealed significantly higher diagnostic performance than mammography for tumors larger than 2 cm. Combined reading showed significantly higher performance than mammography except for tumors smaller than 2 cm. The performance of all three tests was reduced in dense parenchyma, and significantly so for mammographic and combined interpretation.
The accuracy of US in patients with palpable mammographically noncalcified and not obviously malignant breast tumors is lower than reported for mixed sample populations. The accuracy of US may be influenced by breast parenchyma density. Combined reading offers the highest diagnostic accuracy.
分析乳腺钼靶摄影、超声检查（US）以及两者联合检查在评估可触及的非钙化乳腺肿瘤中的诊断准确性。
由四位经验丰富的放射科医生分三个阶段对200例可触及非钙化乳腺肿块患者的乳腺钼靶片和超声图像进行回顾性独立分析：前两个阶段分别进行乳腺钼靶摄影或超声检查解读，最后一个阶段进行联合读片。排除非肿瘤性异常和钼靶摄影显示明显的癌症。根据组织密度和肿瘤大小，对115个（60个良性和55个恶性）肿瘤及其亚组进行受试者操作特征（ROC）分析。通过汇总个体评级获得每个诊断测试的单个ROC曲线。ROC曲线下面积用作诊断性能的指标。
对于大于2cm的肿瘤，超声检查显示出比乳腺钼靶摄影显著更高的诊断性能。联合读片显示出比乳腺钼靶摄影显著更高的性能，但小于2cm的肿瘤除外。在致密实质中，所有三种检查的性能均降低，乳腺钼靶摄影和联合解读显著降低。
对于可触及的钼靶摄影显示非钙化且无明显恶性的乳腺肿瘤患者，超声检查的准确性低于混合样本人群的报告。超声检查的准确性可能受乳腺实质密度影响。联合读片提供最高的诊断准确性。
