Weber Benjamin W, Mao Lu, Salem Kelley, Hitchcock Mary, Keller Abigail H, Elezaby Mai A, Salkowski Lonie R, Bozzuto Laura M, Fowler Amy M
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Radiol Imaging Cancer. 2025 May;7(3):e240281. doi: 10.1148/rycan.240281.
Purpose To perform a systematic review of the literature and meta-analysis to summarize the diagnostic performance of breast imaging modalities for cancer detection in pregnant and lactating patients. Materials and Methods A systematic review of the literature in PubMed, Scopus, Web of Science, and Cochrane Library databases published up until March 3, 2023, was conducted. Included studies evaluated patients of any age who underwent breast imaging during pregnancy or lactation. The primary outcome of this review was sensitivity and specificity of each imaging modality. Meta-analysis was performed using a bivariate modeling approach, and summary receiver operating characteristic (ROC) analysis was used to generate a summary area under the ROC curve (AUC). Results Twenty-five studies met the eligibility criteria and included 1681 female patients (mean age, 33 years; range, 18-49 years). For US, seven of 24 studies had complete data yielding an AUC of 0.90 (95% CI: 0.85, 0.93), a sensitivity of 81% (95% CI: 56, 94), and a specificity of 85% (95% CI: 71, 92). For mammography, three of 21 studies had complete data yielding an AUC of 0.93 (95% CI: 0.75, 0.97), a sensitivity of 72% (95% CI: 47, 88), and a specificity of 93% (95% CI: 86, 97). For MRI, two of eight studies had complete data yielding an AUC of 95% (95% CI: 59, 96), a sensitivity of 91% (95% CI: 56, 99), and a specificity of 88% (95% CI: 48, 98). Conclusion US, mammography, and breast MRI showed high diagnostic performance for detection of pregnancy-associated breast cancer in symptomatic pregnant or lactating patients. Meta-Analysis, Breast, Oncology, Pregnancy, Mammography, MR-Dynamic Contrast Enhanced, Ultrasound © RSNA, 2025.
目的 进行文献系统综述和荟萃分析，以总结乳腺成像模式对妊娠和哺乳期患者癌症检测的诊断性能。材料与方法 对截至2023年3月3日在PubMed、Scopus、Web of Science和Cochrane图书馆数据库中发表的文献进行系统综述。纳入的研究评估了在妊娠或哺乳期接受乳腺成像的任何年龄患者。本综述的主要结果是每种成像模式的敏感性和特异性。采用双变量建模方法进行荟萃分析，并使用汇总接收器操作特征（ROC）分析生成ROC曲线下的汇总面积（AUC）。结果 25项研究符合纳入标准，包括1681例女性患者（平均年龄33岁；范围18 - 49岁）。对于超声检查，24项研究中的7项有完整数据，AUC为0.90（95%CI：0.85，0.93），敏感性为81%（95%CI：56，94），特异性为85%（95%CI：71，92）。对于乳腺X线摄影，21项研究中的3项有完整数据，AUC为0.93（95%CI：0.75，0.97），敏感性为72%（95%CI：47，88），特异性为93%（95%CI：86，97）。对于MRI，8项研究中的2项有完整数据，AUC为95%（95%CI：59，96），敏感性为91%（95%CI：56，99），特异性为88%（95%CI：48，98）。结论 超声检查、乳腺X线摄影和乳腺MRI对有症状的妊娠或哺乳期患者妊娠相关乳腺癌的检测显示出较高的诊断性能。荟萃分析、乳腺、肿瘤学、妊娠、乳腺X线摄影、磁共振动态对比增强、超声 ©RSNA，2025年
