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在克罗地亚国家乳腺筛查项目中,简化乳腺磁共振成像作为有乳腺癌家族风险史人群乳腺钼靶检查的补充手段

Abbreviated Breast MRI as a Supplement to Mammography in Family Risk History of Breast Cancer within the Croatian National Breast Screening Program.

作者信息

Šupe Parun Andrea, Brkljačić Boris, Ivanac Gordana, Tešić Vanja

机构信息

Croatian Institute for Public Health, 10 000 Zagreb, Croatia.

Breast Unit, Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, 10 000 Zagreb, Croatia.

出版信息

Biomedicines. 2024 Oct 16;12(10):2357. doi: 10.3390/biomedicines12102357.

Abstract

OBJECTIVE

To evaluate the diagnostic performance of abbreviated breast MRI compared with mammography in women with a family history of breast cancer included in the Croatian National Breast Screening Program.

METHODS

178 women with a family history of breast cancer aged 50 to 69 underwent abbreviated breast MRI and mammography. Radiological findings for each method were categorized according to the BI-RADS classification. The gold standard for assessing the diagnostic accuracy of breast MRI and mammography, in terms of suspicious BI-RADS 4 and BI-RADS 5 findings, was the histopathological diagnosis. Performance measures, including cancer detection rates, specificity, sensitivity, and positive and negative predictive values, were calculated for both imaging methods.

RESULTS

Twelve new cases of breast cancer were detected, with seven (58.3%) identified only by abbreviated breast MRI, four (33.3%) detected by both mammography and breast MRI, and one (8.3%) diagnosed only by mammography. Diagnostic accuracy parameters for abbreviated breast MRI were 91.67% sensitivity, 94.58% specificity, 55.0% positive predictive value (PPV), and 99.37% negative predictive value (NPV), while for mammography, the corresponding values were 41.67%, 96.39%, 45.46%, and 95.81%, respectively.

CONCLUSIONS

Abbreviated breast MRI is a useful supplement to screening mammography in women with a family history of breast cancer. Considering the results of the conducted research, it is recommended to assess whether women with a family history of breast cancer have an increased risk and subsequently provide annual abbreviated breast MRI in addition to mammography for early detection of breast cancer.

摘要

目的

评估在克罗地亚国家乳腺癌筛查项目中,与乳腺钼靶相比,简化乳腺磁共振成像(MRI)对有乳腺癌家族史女性的诊断性能。

方法

178名年龄在50至69岁、有乳腺癌家族史的女性接受了简化乳腺MRI和乳腺钼靶检查。每种检查方法的影像学结果根据乳腺影像报告和数据系统(BI-RADS)分类进行归类。评估乳腺MRI和乳腺钼靶诊断准确性的金标准,针对可疑的BI-RADS 4类和BI-RADS 5类结果,是组织病理学诊断。计算两种成像方法的性能指标,包括癌症检出率、特异性、敏感性以及阳性和阴性预测值。

结果

共检测出12例新发乳腺癌病例,其中7例(58.3%)仅通过简化乳腺MRI检出,4例(33.3%)通过乳腺钼靶和乳腺MRI均检测出,1例(8.3%)仅通过乳腺钼靶诊断出。简化乳腺MRI的诊断准确性参数为敏感性91.67%、特异性94.58%、阳性预测值(PPV)55.0%和阴性预测值(NPV)99.37%,而乳腺钼靶的相应值分别为41.67%、96.39%、45.46%和95.81%。

结论

简化乳腺MRI是对有乳腺癌家族史女性进行乳腺钼靶筛查的有用补充。考虑到所开展研究的结果,建议评估有乳腺癌家族史的女性是否有更高风险,随后除乳腺钼靶外,每年提供简化乳腺MRI以早期发现乳腺癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0468/11505497/5fb3cdfe4e7f/biomedicines-12-02357-g001.jpg

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