Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia; the University of Melbourne, Parkville, 3010, VIC, Australia.
the University of Melbourne, Parkville, 3010, VIC, Australia.
Breast. 2020 Dec;54:272-277. doi: 10.1016/j.breast.2020.11.007. Epub 2020 Nov 11.
To determine the diagnostic parameters of breast ultrasound (US) in the setting of routine radiological surveillance after a diagnosis of breast cancer and evaluate costs of the inclusion of breast US as well as any survival benefit of US detected cases of recurrence in surveillance.
622 patients underwent breast cancer surgery and follow up at Austin Health from July 2009 to December 2015. Retrospective data analysis was performed to determine; diagnostic parameters, financial costs of US and survival outcomes of US detected cases of recurrence.
Patients underwent 1-9 years of breast cancer surveillance, with a median of 4.24 years. 390 (62.7%) patients underwent additional breast US surveillance to mammography. 232 (38.3%) fit criteria for use of additional breast US. 199 abnormal imaging episodes occurred, leading to 16 screen detected-cases of locoregional recurrence. US alone generated 107 abnormal images and found 9 cancers. US had a sensitivity of 44.1%, specificity of 95.2% and positive predictive value of 11.7% in comparison to mammography; 20.6%, 97.4% and 9.9% respectively. US had a biopsy rate of 4.0% and lead to an incremental cancer detection rate of 0.38%. The cost of incremental cancer found was $31,463.72 AUD. Survival outcomes based on method of detection of recurrence were insignificant (p value = 0.71).
Breast US has a sensitivity of 44.1% and detected seven recurrences that were mammographically occult. Breast US has a similar PPV to mammography in surveillance. Breast US generated considerable biopsy rates and costs. Survival analysis was not able to detect any benefit of US detected cases of recurrence.
确定乳腺癌诊断后常规放射学监测中乳腺超声（US）的诊断参数，并评估包括乳腺 US 在内的成本以及 US 检测到的复发病例的生存获益。
2009 年 7 月至 2015 年 12 月，622 例患者在奥斯汀健康中心接受乳腺癌手术和随访。进行回顾性数据分析，以确定；诊断参数、US 的财务成本以及 US 检测到的复发病例的生存结果。
患者接受了 1-9 年的乳腺癌监测，中位监测时间为 4.24 年。390 例（62.7%）患者在乳腺 X 线摄影的基础上进行了额外的乳腺 US 监测。232 例（38.3%）符合使用额外乳腺 US 的标准。199 次异常影像学检查，导致 16 例局部区域复发的筛查检出病例。单独使用 US 生成了 107 个异常图像并发现了 9 例癌症。与乳腺 X 线摄影相比，US 的敏感性为 44.1%，特异性为 95.2%，阳性预测值为 11.7%；分别为 20.6%、97.4%和 9.9%。US 的活检率为 4.0%，导致额外的癌症检出率为 0.38%。发现的额外癌症的成本为 31463.72 澳元。基于复发检测方法的生存结果无显著差异（p 值=0.71）。
乳腺 US 的敏感性为 44.1%，检测到 7 例乳腺 X 线摄影隐匿性复发。在监测中，乳腺 US 的 PPV 与乳腺 X 线摄影相似。乳腺 US 产生了相当高的活检率和成本。生存分析未能检测到 US 检测到的复发病例的任何获益。
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