Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy.
Università degli Studi di Milano, Milano, Italy.
Tumori. 2021 Apr;107(2):132-138. doi: 10.1177/0300891620930278. Epub 2020 Jun 18.
To investigate the agreement between automated breast ultrasound (ABUS) and hand-held ultrasound (HHUS) in surveillance of women with a history of breast cancer in terms of recurrences or new ipsilateral or contralateral breast cancer.
The institutional review board approved this retrospective study and informed consent was waived. From April to June 2016, women with dense breasts undergoing annual surveillance with mammography and HHUS after breast-conserving surgery were offered supplemental ABUS (Invenia). HHUS was performed by a breast radiologist and ABUS by a trained technician. Images were reviewed by 2 breast radiologists. A per-patient BI-RADS category was independently assigned in all cases and categories were dichotomized into negative (1, 2, 3) and positive (4, 5). Cohen κ, McNemar, and Wilcoxon statistics were used. Final pathology was used as reference standard for malignant lesions.
A total of 154 women (mean age 62±11 years) were enrolled. Time from surgery was a mean of 8±6 years. Cancer prevalence was 4/154 (2.6%). Interreader agreement for ABUS was 1. Intermethod interreader agreement for HHUS and ABUS was substantial for BI-RADS categories (κ = 0.785) and for dichotomic assessment (κ = 0.794). There was no difference in dichotomic assignment between 2 readers ( = 0.5) but a significant difference in assigning BI-RADS categories ( < 0.05).
A substantial agreement resulted between HHUS and ABUS in surveillance of women with a previous history of breast cancer. In particular, ABUS recognized all cancers detected by HHUS and could play a role in first-level surveillance of women at intermediate risk.
探讨自动乳腺超声（ABUS）与手持超声（HHUS）在监测有乳腺癌病史的女性方面的一致性，主要是针对复发性或同侧或对侧新乳腺癌。
该回顾性研究得到了机构审查委员会的批准，且豁免了知情同意。2016 年 4 月至 6 月，接受过保乳手术后每年接受乳房 X 线摄影和 HHUS 监测的致密乳腺女性，可选择补充 ABUS（Invenia）检查。HHUS 由一名乳腺放射科医生进行，ABUS 由一名受过培训的技术员进行。由 2 名乳腺放射科医生对图像进行审查。在所有情况下，均独立为每位患者分配 BI-RADS 类别，并将类别分为阴性（1、2、3）和阳性（4、5）。使用 Cohen κ、McNemar 和 Wilcoxon 统计进行分析。最终病理被用作恶性病变的参考标准。
共有 154 名女性（平均年龄 62±11 岁）入组。从手术到随访的时间平均为 8±6 年。癌症患病率为 4/154（2.6%）。ABUS 的两位读者之间的阅读者间一致性为 1。HHUS 和 ABUS 的方法间阅读者间一致性在 BI-RADS 类别（κ=0.785）和二分类评估（κ=0.794）方面均为高度一致。两位读者在二分类赋值方面没有差异（ = 0.5），但在 BI-RADS 类别赋值方面存在显著差异（<0.05）。
在监测有乳腺癌病史的女性方面，HHUS 和 ABUS 之间存在高度一致。特别是，ABUS 可以识别 HHUS 检测到的所有癌症，在对中危女性进行一级监测方面可能发挥作用。
