Song Sung Eun, Cho Nariya, Chang Jung Min, Chu A Jung, Yi Ann, Moon Woo Kyung
1 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
2 Department of Radiology, Korea University College of Medicine, Seoul, Korea.
Acta Radiol. 2018 May;59(5):533-539. doi: 10.1177/0284185117725779. Epub 2017 Aug 8.
Background Supplemental breast ultrasonography (US) has been used as a surveillance imaging method in women with personal history of breast cancer (PHBC). However, there have been limited data regarding diagnostic performances. Purpose To evaluate diagnostic performances of supplemental breast US screening for women with PHBC and to compare with those for women without PHBC. Material and Methods Between 2011 and 2012, 12,230 supplemental US exams were performed in 12,230 women with negative mammograms: 6584 women with PHBC and 5646 women without PHBC. Cancer detection rate, interval cancer rate, abnormal interpretation rate, positive predictive values (PPVs), sensitivity, and specificity were calculated and compared. Results Overall cancer detection rate and first-year interval cancer rate were 1.80/1000 exams and 0.91/1000 negative exams, both of which were higher in women with PHBC than in women without PHBC (2.88 vs. 0.53 per 1000, P = 0.003; 1.50 vs. 0.20 per 1000, P = 0.027). Abnormal interpretation rate was lower in the women with PHBC than in women without PHBC (9.1% vs. 12.1%, P < 0.001). Sensitivity was not different (67.9% vs. 75.0%, P = 1.000), whereas specificity and PPV were higher in women with PHBC than in women without PHBC (91.2% vs. 88.0%, P < 0.001; 22.6% vs. 3.1%, P < 0.001). The majority of detected cancers in women with PHBC (78.9%, 15/19) were stage 0 or 1. Conclusion Supplemental breast US screening increases early stage second breast cancers with high specificity and PPV in women with PHBC, however, high interval cancer rate in younger women with PHBC should be noted.
补充性乳腺超声检查（US）已被用作有乳腺癌个人史（PHBC）女性的监测成像方法。然而，关于其诊断性能的数据有限。目的：评估补充性乳腺超声筛查对有PHBC女性的诊断性能，并与无PHBC女性的诊断性能进行比较。材料与方法：2011年至2012年期间，对12230名乳腺X线摄影检查结果为阴性的女性进行了12230次补充性超声检查：6584名有PHBC的女性和5646名无PHBC的女性。计算并比较癌症检出率、间期癌症发生率、异常解读率、阳性预测值（PPV）、敏感性和特异性。结果：总体癌症检出率和第一年间期癌症发生率分别为1.80/1000次检查和0.91/1000次阴性检查，两者在有PHBC的女性中均高于无PHBC的女性（每1000次检查中分别为2.88对0.53，P = 0.003；每1000次检查中分别为1.50对0.20，P = 0.027）。有PHBC的女性异常解读率低于无PHBC的女性（9.1%对12.1%，P < 0.001）。敏感性无差异（67.9%对75.0%，P = 1.000），而有PHBC的女性特异性和PPV高于无PHBC的女性（91.2%对88.0%，P < 0.001；22.6%对3.1%，P < 0.001）。有PHBC女性中检测到的大多数癌症（78.9%，15/19）为0期或1期。结论：补充性乳腺超声筛查可提高有PHBC女性早期第二原发性乳腺癌的检出率，特异性和PPV较高，然而，应注意有PHBC的年轻女性间期癌症发生率较高。
