Kim Seung Ja, Moon Woo Kyung, Cho Nariya, Chang Jung Min
Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Korea.
Acta Radiol. 2012 May 1;53(4):376-81. doi: 10.1258/ar.2012.110521. Epub 2012 Mar 8.
The computer-aided detection (CAD) system is widely used for screening mammography. The performance of the CAD system for contralateral breast cancer has not been reported for women with a history of breast cancer.
To retrospectively evaluate the performance of a CAD system on current and previous mammograms in patients with contralateral metachronous breast cancer.
During a 3-year period, 4945 postoperative patients had follow-up examinations, from whom we selected 55 women with contralateral breast cancers. Among them, 38 had visible malignant signs on the current mammograms. We analyzed the sensitivity and false-positive marks of the system on the current and previous mammograms according to lesion type and breast density.
The total visible lesion components on the current mammograms included 27 masses and 14 calcifications in 38 patients. The case-based sensitivity for all lesion types was 63.2% (24/38) with false-positive marks of 0.71 per patient. The lesion-based sensitivity for masses and calcifications was 59.3% (16/27) and 71.4% (10/14), respectively. The lesion-based sensitivity for masses in fatty and dense breasts was 68.8% (11/16) and 45.5% (5/11), respectively. The lesion-based sensitivity for calcifications in fatty and dense breasts was 100.0% (3/3) and 63.6% (7/11), respectively. The total visible lesion components on the previous mammograms included 13 masses and three calcifications in 16 patients, and the sensitivity for all lesion types was 31.3% (5/16) with false-positive marks of 0.81 per patient. On these mammograms, the sensitivity for masses and calcifications was 30.8% (4/13) and 33.3% (1/3), respectively. The sensitivity in fatty and dense breasts was 28.6% (2/7) and 33.3% (3/9), respectively.
In the women with a history of breast cancer, the sensitivity of the CAD system in visible contralateral breast cancer was lower than in most previous reports using the same CAD system probably due to the relatively small size, subtlety of the lesion findings, and dense parenchymal pattern.
计算机辅助检测（CAD）系统广泛应用于乳腺钼靶筛查。对于有乳腺癌病史的女性，尚未有关于CAD系统对侧乳腺癌检测性能的报道。
回顾性评估CAD系统对侧异时性乳腺癌患者当前及既往乳腺钼靶片的检测性能。
在3年期间，4945例术后患者接受了随访检查，从中选取55例患有对侧乳腺癌的女性。其中，38例在当前乳腺钼靶片上有可见的恶性征象。我们根据病变类型和乳腺密度分析了该系统在当前及既往乳腺钼靶片上的敏感性和假阳性标记。
在38例患者的当前乳腺钼靶片上，可见的病变成分共计27个肿块和14处钙化。所有病变类型基于病例的敏感性为63.2%（24/38），每位患者的假阳性标记为0.71。基于病变的肿块和钙化敏感性分别为59.3%（16/27）和71.4%（10/14）。脂肪型和致密型乳腺中肿块基于病变的敏感性分别为68.8%（11/16）和45.5%（5/11）。脂肪型和致密型乳腺中钙化基于病变的敏感性分别为100.0%（3/3）和63.6%（7/11）。既往乳腺钼靶片上可见的病变成分共计16例患者中的13个肿块和3处钙化，所有病变类型的敏感性为31.3%（5/16），每位患者的假阳性标记为0.81。在这些乳腺钼靶片上，肿块和钙化的敏感性分别为30.8%（4/13）和33.3%（1/3）。脂肪型和致密型乳腺中的敏感性分别为28.6%（2/7）和33.3%（3/9）。
在有乳腺癌病史的女性中，CAD系统对可见对侧乳腺癌的敏感性低于大多数既往使用相同CAD系统的报道，这可能是由于病变相对较小、病变表现细微以及实质密度较高。
