Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Thorac Cancer. 2022 Nov;13(22):3145-3151. doi: 10.1111/1759-7714.14666. Epub 2022 Sep 30.
Ultrasound is more widely used than mammography for early diagnosis of breast cancer in China as most Chinese women have small and dense mammary glands. This study compared the diagnostic performance of ultrasound and mammography for breast cancer among Chinese women with suspected breast lesions.
From November 2019 to November 2021, we compared the results of ultrasound and mammography for breast lesion diagnosis in 2737 consecutive participants with suspected breast lesions; all patients underwent biopsies. We measured the sensitivity, specificity, and diagnostic accuracy separately.
Among the 2737 participants, 2844 breast lesions were detected, including 1935 (68.0%) breast cancers and 909 (32.0%) benign lesions. Of the breast cancers, ultrasound detected 1851 (95.7%), whereas mammography detected 1527 (78.9%). The sensitivity of ultrasound for breast cancer diagnosis was significantly higher than that of mammography (95.7% vs. 78.9%, p < 0.001), whereas the specificity was significantly lower than that of mammography (42.9% vs. 62.3%, p < 0.001). The receiver operating characteristic curves revealed that ultrasound was more accurate in detecting breast cancer than mammography (76.8% vs. 71.3%, p < 0.001). Age, body mass index, and breast density did not influence ultrasound sensitivity and accuracy.
Ultrasound is more sensitive and accurate than mammography and detects more breast cancers with a lower specificity.
在中国,由于大多数中国女性的乳腺致密且体积小,超声检查比乳腺 X 线摄影术更广泛地用于乳腺癌的早期诊断。本研究比较了超声和乳腺 X 线摄影术在疑似乳腺病变的中国女性中的乳腺癌诊断性能。
2019 年 11 月至 2021 年 11 月,我们比较了 2737 例连续疑似乳腺病变患者的超声和乳腺 X 线摄影检查结果;所有患者均接受了活检。我们分别测量了灵敏度、特异性和诊断准确性。
在 2737 名参与者中,共检测到 2844 个乳腺病变,包括 1935 个(68.0%)乳腺癌和 909 个(32.0%)良性病变。在乳腺癌中,超声检出 1851 例(95.7%),而乳腺 X 线摄影术检出 1527 例(78.9%)。超声对乳腺癌的诊断灵敏度明显高于乳腺 X 线摄影术(95.7%比 78.9%,p < 0.001),而特异性明显低于乳腺 X 线摄影术(42.9%比 62.3%,p < 0.001)。受试者工作特征曲线显示,超声在检测乳腺癌方面比乳腺 X 线摄影术更准确(76.8%比 71.3%,p < 0.001)。年龄、体重指数和乳腺密度均不影响超声的灵敏度和准确性。
超声比乳腺 X 线摄影术更敏感、更准确,检出的乳腺癌更多,但特异性更低。