Arleo Elizabeth Kagan, Saleh Marwa, Ionescu Dana, Drotman Michele, Min Robert J, Hentel Keith
New York-Presbyterian/Weill Cornell Medical College, 425 East 61st Street, 9th floor, New York, NY 10128.
New York-Presbyterian/Weill Cornell Medical College, 425 East 61st Street, 9th floor, New York, NY 10128.
Clin Imaging. 2014 Jul-Aug;38(4):439-444. doi: 10.1016/j.clinimag.2014.03.012. Epub 2014 Apr 1.
The aim of this study was to determine the recall rate of screening ultrasound with automated breast volumetric scanning (ABVS) in women with dense breasts (BI-RADS density classification 3 or 4 on mammogram).
In this retrospective cohort study, at the end of the "first quarter" (August-October 2013) of use, our practice database was searched for all ABVS examinations performed and specifically, the positive examinations (defined as abnormal/BI-RADS 0) for which patients were recalled for additional imaging evaluation with handheld ultrasound (HHUS); the latter group was reviewed with respect to final BI-RADS and pathology if relevant.
During the 3-month study time period, 558 ABVS studies were performed: 453 (81%) were initially BI-RADS 1 or 2 and 105 (19%) were BI-RADS 0-incomplete and recalled, corresponding with an overall recall rate of 19%; specifically, the recall rate trended down from 24.7% in August to 12.6% in October. To date, 98 of the 105 recalled women have returned for HHUS, with the resultant final BI-RADS as follows: 25/98=25% BI-RADS 1, 46/98=47% BI-RADS 2, 13/98=13% BI-RADS 3, 14/98=15% BI-RADS 4, and 0/98=0% BI-RADS 5. All biopsies performed to date of the ABVS-detected BI-RADS 4 lesions have yielded benign results, with the most common pathology being fibroadenoma.
The recall rate of screening ABVS in women with dense breasts at our institution was under 20% overall during its first quarter of use, and trended down from nearly 25% in the first month to under 13% in the third. The clinical implication is that ABVS does have a learning curve, but that is a potentially feasible way to meet the increasing demands for screening ultrasound in women with dense breasts.
本研究旨在确定在乳腺致密（乳腺钼靶检查的BI-RADS密度分类为3或4）的女性中，使用自动乳腺容积扫描（ABVS）进行筛查超声检查的召回率。
在这项回顾性队列研究中，在使用“第一季度”（2013年8月至10月）结束时，在我们的实践数据库中搜索了所有进行的ABVS检查，具体而言，搜索了那些被召回进行手持超声（HHUS）额外影像评估的阳性检查（定义为异常/BI-RADS 0）；如果相关，对后一组进行了最终BI-RADS和病理检查的回顾。
在3个月的研究时间段内，共进行了558例ABVS检查：453例（占81%）最初为BI-RADS 1或2，105例（占19%）为BI-RADS 0 - 不完整并被召回，总体召回率为19%；具体而言，召回率从8月的24.7%降至10月的12.6%。截至目前，105名被召回的女性中有98名已返回进行HHUS检查，最终的BI-RADS结果如下：25/98 = 25%为BI-RADS 1，46/98 = 47%为BI-RADS 2，13/98 = 13%为BI-RADS 3，14/98 = 15%为BI-RADS 4，0/98 = 0%为BI-RADS 5。到目前为止，对ABVS检测到的BI-RADS 4级病变进行的所有活检结果均为良性，最常见的病理类型为纤维腺瘤。
在我们机构，乳腺致密的女性使用ABVS进行筛查的召回率在使用的第一季度总体低于20%，且从第一个月的近25%降至第三个月的低于13%。其临床意义在于，ABVS确实存在学习曲线，但这是满足乳腺致密女性对筛查超声检查日益增长需求的一种潜在可行方法。
