Aase H S, Danielsen A S, Hoff S R, Holen Å S, Haldorsen I S, Hovda T, Hanestad B, Sandvik C K, Hofvind S
Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway.
Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway; Norwegian Institute of Public Health, Oslo, Norway.
Eur J Radiol. 2021 Aug;141:109753. doi: 10.1016/j.ejrad.2021.109753. Epub 2021 May 5.
To compare the distribution of mammographic features among women recalled for further assessment after screening with digital breast tomosynthesis (DBT) versus digital mammography (DM), and to assess associations between features and final outcome of the screening, including immunohistochemical subtypes of the tumour.
This randomized controlled trial was performed in Bergen, Norway, and included 28,749 women, of which 1015 were recalled due to mammographic findings. Mammographic features were classified according to a modified BI-RADS-scale. The distribution were compared using 95 % confidence intervals (CI).
Asymmetry was the most common feature of all recalls, 24.3 % (108/444) for DBT and 38.9 % (222/571) for DM. Spiculated mass was most common for breast cancer after screening with DBT (36.8 %, 35/95, 95 %CI: 27.2-47.4) while calcifications (23.0 %, 20/87, 95 %CI: 14.6-33.2) was the most frequent after DM. Among women screened with DBT, 0.13 % (95 %CI: 0.08-0.21) had benign outcome after recall due to indistinct mass while the percentage was 0.28 % (95 %CI: 0.20-0.38) for DM. The distributions were 0.70 % (95 %CI: 0.57-0.85) versus 1.46 % (95 %CI: 1.27-1.67) for asymmetry and 0.24 % (95 %CI: 0.16-0.33) versus 0.54 % (95 %CI: 0.43-0.68) for obscured mass, among women screened with DBT versus DM, respectively. Spiculated mass was the most common feature among women diagnosed with non-luminal A-like cancer after DBT and after DM.
Spiculated mass was the dominant feature for breast cancer among women screened with DBT while calcifications was the most frequent feature for DM. Further studies exploring the clinical relevance of mammographic features visible particularly on DBT are warranted.
比较经数字乳腺断层合成（DBT）与数字乳腺X线摄影（DM）筛查后被召回做进一步评估的女性中乳腺X线特征的分布情况，并评估这些特征与筛查最终结果之间的关联，包括肿瘤的免疫组织化学亚型。
这项随机对照试验在挪威卑尔根进行，纳入了28749名女性，其中1015名因乳腺X线检查结果被召回。乳腺X线特征根据改良的乳腺影像报告和数据系统（BI-RADS）分级进行分类。使用95%置信区间（CI）比较分布情况。
不对称是所有召回病例中最常见的特征，DBT组为24.3%（108/444），DM组为38.9%（222/571）。经DBT筛查后，毛刺状肿块是乳腺癌最常见的特征（36.8%，35/95，95%CI：27.2 - 47.4），而经DM筛查后钙化是最常见的特征（23.0%，20/87，95%CI：14.6 - 33.2）。在经DBT筛查的女性中，因肿块不清晰被召回后0.13%（95%CI：0.08 - 0.21）为良性结果，而DM组这一比例为0.28%（95%CI：0.20 - 0.38）。DBT组和DM组筛查的女性中，不对称的分布分别为0.70%（95%CI：0.57 - 0.85）和1.46%（95%CI：1.27 - 1.67），模糊肿块的分布分别为0.24%（95%CI：0.16 - 0.33）和0.54%（95%CI：0.43 - 0.68）。毛刺状肿块是经DBT和DM筛查后被诊断为非腔面A型样癌症的女性中最常见的特征。
经DBT筛查的女性中，毛刺状肿块是乳腺癌的主要特征，而经DM筛查的女性中钙化是最常见的特征。有必要进一步研究探索尤其在DBT上可见的乳腺X线特征的临床相关性。
