University of Washington, Department of Radiology, Seattle Cancer Care Alliance, 825 Eastlake Avenue East, G2-600, Seattle, WA 98109-1023, United States of America.
University of Washington, Department of Radiology, Seattle Cancer Care Alliance, 825 Eastlake Avenue East, G2-600, Seattle, WA 98109-1023, United States of America.
Clin Imaging. 2019 May-Jun;55:119-125. doi: 10.1016/j.clinimag.2019.01.019. Epub 2019 Jan 23.
To evaluate the impact of double reading automated breast ultrasound (ABUS) when added to full field digital mammography (FFDM) or digital breast tomosynthesis (DBT) for breast cancer screening.
From April 2014 to June 2015, 124 women with dense breasts and intermediate to high breast cancer risk were recruited for screening with FFDM, DBT, and ABUS. Readers used FFDM and DBT in clinical practice and received ABUS training prior to study initiation. FFDM or DBT were first interpreted alone by two independent readers and then with ABUS. All recalled women underwent diagnostic workup with at least one year of follow-up. Recall rates were compared using the sign test; differences in outcomes were evaluated using Fisher's exact test.
Of 121 women with complete follow-up, all had family (35.5%) or personal (20.7%) history of breast cancer, or both (43.8%). Twenty-four women (19.8%) were recalled by at least one modality. Recalls increased from 5.0% to 13.2% (p = 0.002) when ABUS was added to FFDM and from 3.3% to 10.7% (p = 0.004) when ABUS was added to DBT. Findings recalled by both readers were more likely to result in a recommendation for short term follow-up imaging or tissue biopsy compared to findings recalled by only one reader (100% vs. 42.1%, p = 0.041). The cancer detection rate was 8.3 per 1000 screens (1/121); mode of detection: FFDM and DBT.
Adding ABUS significantly increased the recall rate of both FFDM and DBT screening. Double reading of ABUS during early phase adoption may reduce false positive recalls.
评估在全数字化乳腺摄影（FFDM）或数字化乳腺断层摄影术（DBT）基础上增加自动乳腺超声（ABUS）双读对乳腺癌筛查的影响。
2014 年 4 月至 2015 年 6 月，招募 124 例乳腺致密且具有中高危乳腺癌风险的女性进行 FFDM、DBT 和 ABUS 筛查。两位独立的读者在临床实践中使用 FFDM 和 DBT，并在研究开始前接受 ABUS 培训。首先单独对 FFDM 或 DBT 进行解读，然后结合 ABUS 进行解读。所有召回的女性均进行了诊断性检查，并进行了至少一年的随访。采用符号检验比较召回率；采用 Fisher 确切检验比较结果差异。
在 121 例完成随访的女性中，所有女性均有家族（35.5%）或个人（20.7%）乳腺癌病史，或两者兼有（43.8%）。24 例（19.8%）女性至少有一种检查方式被召回。当 ABUS 被添加到 FFDM 时，召回率从 5.0%增加到 13.2%（p=0.002）；当 ABUS 被添加到 DBT 时，召回率从 3.3%增加到 10.7%（p=0.004）。与仅一位读者召回的结果相比，两位读者均召回的结果更可能建议进行短期随访影像学检查或组织活检（100%比 42.1%，p=0.041）。乳腺癌检出率为 8.3/1000 例（1/121）；检出方式：FFDM 和 DBT。
在 FFDM 和 DBT 筛查中增加 ABUS 显著增加了召回率。在早期采用 ABUS 双读可能会减少假阳性召回。
