Qi Long-Xiu, Zhou Xiao, Fu Yi-Gang, Zhou Wen-Yan
Department of Radiology, Yancheng No. 1 People's Hospital (The First People's Hospital of Yancheng), Affiliated Hospital of Medical School, Nanjing University, Yancheng, Jiangsu 224000, P.R. China.
Department of Ultrasound, Yancheng No. 1 People's Hospital (The First People's Hospital of Yancheng), Affiliated Hospital of Medical School, Nanjing University, Yancheng, Jiangsu 224000, P.R. China.
Oncol Lett. 2024 Dec 3;29(2):85. doi: 10.3892/ol.2024.14831. eCollection 2025 Feb.
Breast cancer is one of the most common malignancies affecting women worldwide, and an early diagnosis is critical for improving prognosis. The present study aimed to investigate the diagnostic value of mammography (MG) combined with ultrasound shear wave elastography (SWE) and magnetic resonance imaging (MRI) for the early screening of breast cancer. Patients with breast tumors who underwent lumpectomy at a single hospital between December 2021 and January 2023 were selected and categorized into a benign or malignant group based on pathological findings. All patients had undergone examinations with MG, SWE and MRI. Imaging parameters were subsequently compared between the two groups. A total of 93 patients with breast tumors were included in the study, comprising 37 individuals in the benign group and 56 in the malignant group. MG findings revealed that patients in the malignant group exhibited significantly higher incidences of high breast glandular density, irregular mass margins, unclear mass borders and axillary lymph node involvement compared with those in the benign group. SWE results indicated that the elasticity ratio of the lesion to fat, and the mean and maximum values of the elastic modulus were significantly lower in the benign group than in the malignant group. Additionally, MRI findings demonstrated that the MRI-measured maximum diameter was larger, and the prevalence of irregular lesion morphology, irregular mass margins, signal enhancement and type III time-signal intensity curves was greater in the malignant group compared with the benign group. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of MG + SWE + MRI were 94.6, 86.5, 91.4 and 91.4%, respectively. Furthermore, the diagnostic efficacy of this combination surpassed that of MG + SWE, MG + MRI and SWE + MRI (area under the curve, 0.906 vs. 0.767, 0.758 and 0.763, respectively). In conclusion, the combination of MG with SWE and MRI exhibits a superior performance in the early diagnosis of breast cancer, exhibiting higher diagnostic accuracy and reliability compared with pairwise combinations.
乳腺癌是全球影响女性的最常见恶性肿瘤之一，早期诊断对于改善预后至关重要。本研究旨在探讨乳腺钼靶摄影（MG）联合超声剪切波弹性成像（SWE）及磁共振成像（MRI）对乳腺癌早期筛查的诊断价值。选取2021年12月至2023年1月在某单一医院接受肿块切除术的乳腺肿瘤患者，根据病理结果分为良性或恶性组。所有患者均接受了MG、SWE和MRI检查。随后比较两组的影像学参数。本研究共纳入93例乳腺肿瘤患者，其中良性组37例，恶性组56例。MG检查结果显示，与良性组相比，恶性组患者乳腺腺体密度高、肿块边缘不规则、肿块边界不清及腋窝淋巴结受累的发生率显著更高。SWE结果表明，良性组病变与脂肪的弹性比、弹性模量的均值和最大值均显著低于恶性组。此外，MRI检查结果显示，与良性组相比，恶性组MRI测量的最大直径更大，病变形态不规则、肿块边缘不规则、信号增强及III型时间-信号强度曲线的发生率更高。MG+SWE+MRI的诊断敏感性、特异性、阳性预测值和阴性预测值分别为94.6%、86.5%、91.4%和91.4%。此外，该联合检查的诊断效能超过了MG+SWE、MG+MRI和SWE+MRI（曲线下面积分别为0.906 vs. 0.767、0.758和0.763）。总之，MG联合SWE和MRI在乳腺癌早期诊断中表现出卓越性能，与两两联合相比具有更高的诊断准确性和可靠性。
