Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
Institute of Statistics, National University of Kaohsiung, Kaohsiung, Taiwan, ROC.
J Chin Med Assoc. 2018 Jan;81(1):70-80. doi: 10.1016/j.jcma.2017.05.013. Epub 2017 Nov 9.
To determine if mammography combined with digital breast tomosynthesis (DBT), leads to superior performance in screening for breast cancer compared to digital mammography (DM) alone.
We retrospectively collected data from A) the results of population-based mammography-screening provided by the National Cancer Registry in Taiwan, and B) the results from all screening mammography performed with DBT from 2012 through 2015 at Kaohsiung Veterans General Hospital (VGHKS) since the institution of DBT at the end of 2011. This was compared data from 3 years with DM performed prior to DBT implementation. We calculated the results of medical audit of VGHKS and compared this with national data. Fisher's exact test is applied.
VGHKS data demonstrated a higher cancer detection rate (CDR) and positive predictive value 1 (PPV 1) than the national average. Most prominently in the year 2014, our CDR was 120% better than that of the national average. CDR ranged from 6.3 to 8.1‰ prior to the introduction of DBT, and following DBT implementation this improved to 8.5-11.4‰, reflecting a mean increase of 32.2%. Early cancer detection was 50% higher and node negative rate was 25% higher than the national average of latest year. A 17.8% reduction in recall rate (RR) was achieved due to a decrease in unnecessary recall.
There was a 32.2% increase in CDR and a 17.8% decrease in RR when DBT was used as an adjunct to DM, as compared to DM alone. CDRs were approximately twofold better than national average data. DBT was more effective at detecting cancer in ductal carcinoma in situ and stage 1.
为了确定与单纯数字乳腺 X 线摄影（DM）相比，乳腺 X 线摄影联合数字乳腺断层摄影（DBT）在乳腺癌筛查中的表现是否更优。
我们回顾性地收集了来自台湾国家癌症登记处提供的基于人群的乳腺 X 线筛查结果（A），以及 2011 年底在高雄荣民总医院（VGHKS）进行的 2012 年至 2015 年所有 DBT 筛查乳腺 X 线摄影结果（B）。这与 DBT 实施前 3 年的 DM 数据进行了比较。我们计算了 VGHKS 的医学审核结果，并与国家数据进行了比较。应用 Fisher 确切检验。
VGHKS 数据显示癌症检出率（CDR）和阳性预测值 1（PPV1）高于全国平均水平。在 2014 年，我们的 CDR 比全国平均水平高出 120%。在引入 DBT 之前，CDR 范围为 6.3 至 8.1‰，在实施 DBT 之后，这一数字提高到 8.5-11.4‰，平均增长 32.2%。早期癌症检出率比全国平均水平高 50%，淋巴结阴性率高 25%。由于不必要的召回减少，召回率（RR）降低了 17.8%。
与单纯 DM 相比，DBT 作为 DM 的辅助手段，CDR 增加了 32.2%，RR 降低了 17.8%。CDR 约为全国平均数据的两倍。DBT 在检测导管原位癌和 1 期癌方面更有效。
