Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta.
School of Health and Society, University of Salford, Manchester M5 4WT, United Kingdom.
Eur J Radiol. 2022 Sep;154:110416. doi: 10.1016/j.ejrad.2022.110416. Epub 2022 Jun 22.
To systematically review studies on the effectiveness of supplementary imaging for breast cancer screening in women with dense breasts.
A systematic search of peer-reviewed publications in English (January 2000 to March 2021) was carried out. Eight databases were used to retrieve the studies: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Clinical Answers, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, PubMed, and Web of Science. Two radiographers and an academic independently reviewed the articles to determine if the studies met inclusion criteria. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Summary estimates of diagnostic accuracy were obtained by using proportion and diagnostic metanalysis.
From 3764 studies that underwent title and abstract screening, 221 studies underwent full-text screening. Of these 42 were included in the qualitative and quantitative synthesis. Results for sensitivity, specificity, positive and negative predictive values, cancer detection rates, recall and biopsy rates in women with dense breasts undergoing supplementary imaging were reported. Studies included in this review were heterogeneous, as was the proportion of women undergoing prevalence and incidence screening rounds.
Supplementary screening among women with dense breasts who had recent negative mammograms can consistently identify additional cancers and lead to further recalls and biopsies.
系统评价致密型乳腺女性乳腺癌筛查中补充性影像学检查的有效性。
对 2000 年 1 月至 2021 年 3 月期间发表的英文同行评审文献进行了系统检索。使用了 8 个数据库来检索研究:MEDLINE、CINAHL、Cochrane 对照试验中心注册库、Cochrane 临床解答、Cochrane 系统评价数据库、Cochrane 方法学登记册、PubMed 和 Web of Science。两名放射技师和一名学术人员独立审查了这些文章,以确定研究是否符合纳入标准。使用诊断准确性研究质量评估工具-2 对研究质量进行评估。使用比例和诊断荟萃分析获得了诊断准确性的综合估计值。
经过标题和摘要筛选的 3764 项研究中,有 221 项进行了全文筛选。其中 42 项被纳入定性和定量综合分析。报告了致密型乳腺女性接受补充性影像学检查的敏感性、特异性、阳性和阴性预测值、癌症检出率、召回率和活检率。本综述纳入的研究存在异质性,接受患病率和发病率筛查轮次的女性比例也存在异质性。
对近期阴性乳腺 X 线摄影检查的致密型乳腺女性进行补充性筛查可以一致地识别出更多的癌症,并导致更多的召回和活检。