Taif Sawsan, Tufail Fatma, Alnuaimi Ahmed Sameer
Department of Radiology, Khoula Hospital, Muscat, Oman.
Department of Community Medicine, Baghdad College of Medicine, Baghdad, Iraq.
Asia Pac J Clin Oncol. 2016 Jun;12(2):e250-8. doi: 10.1111/ajco.12181. Epub 2014 Mar 27.
The aim of this study is to assess mammography performance in Oman by estimating the breast cancer rate and the positive predictive value (PPV) with the influence of some variables.
This cross-sectional study was conducted on mammograms done in one of the three main breast imaging centers in Oman between January 2008 and July 2012. Diagnostic and screening groups were identified and assessed separately. Rate of abnormal mammograms, rate of breast cancer and the PPV were estimated according to Breast Imaging Reporting and Data System (BIRADS) score, presence of breast lump and patient's age.
Total of 653 mammograms were included, 254 diagnostic and 399 screening. Abnormal mammograms (BIRADS 4 and 5) form 31.9% of the diagnostic examinations compared with 6.8% of screening examinations. Breast cancer was present in 17.9% of the diagnostic compared with 1.0% of the screening group. The PPV of BIRADS 5 was 94.1%, and for BIRADS 4 was 37.1 and 26.7% for diagnostic and screening studies. Overall PPV for abnormal mammograms was 65.2% in the diagnostic and 26.7% in the screening group. Mammography PPV shows positive association with age (P = 0.039) while presence of breast lump has no significant effect on the PPV (P = 0.38).
BIRADS 5 score was found to have a high cancer yield making it a strong predictor of cancer. Different results were obtained in the diagnostic compared with screening mammography with higher rates of abnormal mammograms and breast cancer. Mammography performance should be better in the older women.
本研究旨在通过估计乳腺癌发病率和阳性预测值（PPV），并考虑一些变量的影响，评估阿曼的乳房X线摄影性能。
本横断面研究对2008年1月至2012年7月在阿曼三个主要乳房成像中心之一进行的乳房X线摄影进行。分别识别和评估诊断组和筛查组。根据乳房影像报告和数据系统（BIRADS）评分、乳房肿块的存在情况和患者年龄，估计乳房X线摄影异常率、乳腺癌发病率和PPV。
共纳入653例乳房X线摄影，其中254例为诊断性检查，399例为筛查性检查。诊断性检查中异常乳房X线摄影（BIRADS 4和5）占31.9%，而筛查性检查中占6.8%。诊断组中乳腺癌占17.9%，而筛查组中占1.0%。BIRADS 5的PPV为94.1%，BIRADS 4在诊断性研究和筛查性研究中的PPV分别为37.1%和26.7%。诊断组中异常乳房X线摄影的总体PPV为65.2%，筛查组中为26.7%。乳房X线摄影PPV与年龄呈正相关（P = 0.039），而乳房肿块的存在对PPV无显著影响（P = 0.38）。
发现BIRADS 5评分具有较高的癌症检出率，使其成为癌症的有力预测指标。诊断性乳房X线摄影与筛查性乳房X线摄影的结果不同，异常乳房X线摄影和乳腺癌的发生率更高。老年女性乳房X线摄影性能应该更好。
