1 Department of Radiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 4032, Kansas City, KS 66160.
2 Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO.
AJR Am J Roentgenol. 2018 Jan;210(1):W22-W28. doi: 10.2214/AJR.17.18158. Epub 2017 Oct 18.
Supplemental screening with ultrasound has been shown to detect additional breast malignancies in women with dense breast tissue and normal mammogram findings. The frequency of supplemental screening with automated breast ultrasound and the effect and type of breast tissue density notification on automated screening breast ultrasound utilization rates are unknown.
We examined normal mammogram results letters for patients with heterogeneously or extremely dense breast tissue between July 1, 2013, and June 30, 2014, by type of results letter, notification method, and sociodemographic characteristics. Logistic regression was used to examine the association between type of results letter and subsequent automated screening breast ultrasound.
Among 3012 women with dense breast tissue and normal mammogram findings, 15% returned for supplemental automated screening breast ultrasound within 18 months of results letter notification. Compared with a similarly sized control group of women who did not undergo automated ultrasound, a significantly greater proportion of patients (86.9%) returned for breast ultrasound if they received a results letter indicating breast density in combination with a courtesy phone call (p < 0.001). Patients who received results letters with breast density notification including a statement that they may benefit from additional screening with automated breast ultrasound examination were 9.91 times (95% CI, 6.08-16.16) more likely to return for the examination than patients who did not receive breast density notification or mention of supplemental screening.
Patient breast density notification and radiologists' recommendations for supplemental screening with breast ultrasound increase patient utilization of automated screening breast ultrasound examinations.
研究表明，对于乳腺组织致密且乳腺 X 线摄影检查结果正常的女性，采用超声进行补充筛查可检测到更多的乳腺恶性肿瘤。目前尚不清楚采用自动乳腺超声进行补充筛查的频率，以及乳腺组织密度通知对自动筛查乳腺超声利用率的影响和类型。
我们通过结果通知类型、通知方式和社会人口统计学特征，对 2013 年 7 月 1 日至 2014 年 6 月 30 日期间乳腺组织致密且乳腺 X 线摄影检查结果正常的患者的乳腺 X 线摄影检查结果通知单进行了检查。采用逻辑回归分析结果通知单类型与随后的自动筛查乳腺超声之间的关系。
在 3012 例乳腺组织致密且乳腺 X 线摄影检查结果正常的女性中，有 15%的患者在结果通知单通知后 18 个月内接受了补充的自动筛查乳腺超声检查。与未接受自动超声检查的大小相似的对照组患者相比，如果患者收到的结果通知单中同时提示乳腺密度并附有电话回访，那么有更大比例（86.9%）的患者会返回进行乳腺超声检查（p < 0.001）。与未收到乳腺密度通知或未提及补充筛查的患者相比，收到包含“患者可能受益于自动乳腺超声检查”这一内容的乳腺密度通知的患者返回进行检查的可能性要高出 9.91 倍（95%CI，6.08-16.16）。
患者乳腺密度通知和放射科医生对乳腺超声补充筛查的建议可增加患者对自动筛查乳腺超声检查的利用。
