Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females

Henglei Dong, Yubei Huang, Fengju Song, Hongji Dai, Peifang Liu, Ying Zhu, Peishan Wang, Jiali Han, Xishan Hao, Kexin Chen

Research output: Contribution to journalArticle

Abstract

Introduction: Until now, no studies have investigated whether women other than those with dense breasts are suitable for adjunctive ultrasonography after negative mammography, and investigated whether all women with negative mammography are suitable for adjunctive ultrasonography. Methods: Based on the Multi-modality Independent Screening Trial in China, a total of 31,918 women aged 45 to 65 years underwent both ultrasonography and mammography. Physicians performed ultrasonography and mammography separately and were blinded to each other's findings until their interpretations had been recorded. For both ultrasonography and mammography, suspicious results and those highly suggestive of a malignancy were confirmed by pathologic examination, whereas other results were confirmed by 1-year follow-up after initial screening. Results: Based on Breast Imaging Reporting and Data System (BIRADS) assessments, 84 (84.8%) of 99 cancers were identified on mammography (detection rate, 2.6/1000), and 61 (61.6%) of 99 cancers were identified on ultrasonography (detection rate, 1.9/1000). Integrated mammography with ultrasonography identified 94 (95.0%) of 99 cancers, with an increment of 11.9% in cancer detection rate (from 2.6/1000 to 2.9/1000) (P < .05). Moreover, among women with BIRADS 3, adjunctive ultrasonography detected no cancers. All 10 additional cancers detected by adjunctive ultrasonography were from women with BIRADS 0 to 2, at a cost of 207 women with false positives. Additionally, dense breasts and benign breast disease were significantly associated with positive ultrasonography after BIRADS 0 to 2 (all P values < .05). Conclusions: After negative mammography, adjunctive ultrasonography should only be recommended for BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease.

Original languageEnglish (US)
JournalClinical Breast Cancer
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Mammography
Ultrasonography
Breast Neoplasms
Breast
Information Systems
Neoplasms
Breast Diseases
Mammary Ultrasonography
China
Physicians
Costs and Cost Analysis

Keywords

  • Breast cancer
  • Chinese women
  • Mammography
  • Screening
  • Ultrasonography

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females. / Dong, Henglei; Huang, Yubei; Song, Fengju; Dai, Hongji; Liu, Peifang; Zhu, Ying; Wang, Peishan; Han, Jiali; Hao, Xishan; Chen, Kexin.

In: Clinical Breast Cancer, 01.01.2017.

Research output: Contribution to journalArticle

Dong, Henglei ; Huang, Yubei ; Song, Fengju ; Dai, Hongji ; Liu, Peifang ; Zhu, Ying ; Wang, Peishan ; Han, Jiali ; Hao, Xishan ; Chen, Kexin. / Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females. In: Clinical Breast Cancer. 2017.
@article{88c2b09ad8b04c428074661845e365cd,
title = "Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females",
abstract = "Introduction: Until now, no studies have investigated whether women other than those with dense breasts are suitable for adjunctive ultrasonography after negative mammography, and investigated whether all women with negative mammography are suitable for adjunctive ultrasonography. Methods: Based on the Multi-modality Independent Screening Trial in China, a total of 31,918 women aged 45 to 65 years underwent both ultrasonography and mammography. Physicians performed ultrasonography and mammography separately and were blinded to each other's findings until their interpretations had been recorded. For both ultrasonography and mammography, suspicious results and those highly suggestive of a malignancy were confirmed by pathologic examination, whereas other results were confirmed by 1-year follow-up after initial screening. Results: Based on Breast Imaging Reporting and Data System (BIRADS) assessments, 84 (84.8{\%}) of 99 cancers were identified on mammography (detection rate, 2.6/1000), and 61 (61.6{\%}) of 99 cancers were identified on ultrasonography (detection rate, 1.9/1000). Integrated mammography with ultrasonography identified 94 (95.0{\%}) of 99 cancers, with an increment of 11.9{\%} in cancer detection rate (from 2.6/1000 to 2.9/1000) (P < .05). Moreover, among women with BIRADS 3, adjunctive ultrasonography detected no cancers. All 10 additional cancers detected by adjunctive ultrasonography were from women with BIRADS 0 to 2, at a cost of 207 women with false positives. Additionally, dense breasts and benign breast disease were significantly associated with positive ultrasonography after BIRADS 0 to 2 (all P values < .05). Conclusions: After negative mammography, adjunctive ultrasonography should only be recommended for BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease.",
keywords = "Breast cancer, Chinese women, Mammography, Screening, Ultrasonography",
author = "Henglei Dong and Yubei Huang and Fengju Song and Hongji Dai and Peifang Liu and Ying Zhu and Peishan Wang and Jiali Han and Xishan Hao and Kexin Chen",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.clbc.2017.07.014",
language = "English (US)",
journal = "Clinical Breast Cancer",
issn = "1526-8209",
publisher = "Elsevier",

}

TY - JOUR

T1 - Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females

AU - Dong, Henglei

AU - Huang, Yubei

AU - Song, Fengju

AU - Dai, Hongji

AU - Liu, Peifang

AU - Zhu, Ying

AU - Wang, Peishan

AU - Han, Jiali

AU - Hao, Xishan

AU - Chen, Kexin

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Introduction: Until now, no studies have investigated whether women other than those with dense breasts are suitable for adjunctive ultrasonography after negative mammography, and investigated whether all women with negative mammography are suitable for adjunctive ultrasonography. Methods: Based on the Multi-modality Independent Screening Trial in China, a total of 31,918 women aged 45 to 65 years underwent both ultrasonography and mammography. Physicians performed ultrasonography and mammography separately and were blinded to each other's findings until their interpretations had been recorded. For both ultrasonography and mammography, suspicious results and those highly suggestive of a malignancy were confirmed by pathologic examination, whereas other results were confirmed by 1-year follow-up after initial screening. Results: Based on Breast Imaging Reporting and Data System (BIRADS) assessments, 84 (84.8%) of 99 cancers were identified on mammography (detection rate, 2.6/1000), and 61 (61.6%) of 99 cancers were identified on ultrasonography (detection rate, 1.9/1000). Integrated mammography with ultrasonography identified 94 (95.0%) of 99 cancers, with an increment of 11.9% in cancer detection rate (from 2.6/1000 to 2.9/1000) (P < .05). Moreover, among women with BIRADS 3, adjunctive ultrasonography detected no cancers. All 10 additional cancers detected by adjunctive ultrasonography were from women with BIRADS 0 to 2, at a cost of 207 women with false positives. Additionally, dense breasts and benign breast disease were significantly associated with positive ultrasonography after BIRADS 0 to 2 (all P values < .05). Conclusions: After negative mammography, adjunctive ultrasonography should only be recommended for BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease.

AB - Introduction: Until now, no studies have investigated whether women other than those with dense breasts are suitable for adjunctive ultrasonography after negative mammography, and investigated whether all women with negative mammography are suitable for adjunctive ultrasonography. Methods: Based on the Multi-modality Independent Screening Trial in China, a total of 31,918 women aged 45 to 65 years underwent both ultrasonography and mammography. Physicians performed ultrasonography and mammography separately and were blinded to each other's findings until their interpretations had been recorded. For both ultrasonography and mammography, suspicious results and those highly suggestive of a malignancy were confirmed by pathologic examination, whereas other results were confirmed by 1-year follow-up after initial screening. Results: Based on Breast Imaging Reporting and Data System (BIRADS) assessments, 84 (84.8%) of 99 cancers were identified on mammography (detection rate, 2.6/1000), and 61 (61.6%) of 99 cancers were identified on ultrasonography (detection rate, 1.9/1000). Integrated mammography with ultrasonography identified 94 (95.0%) of 99 cancers, with an increment of 11.9% in cancer detection rate (from 2.6/1000 to 2.9/1000) (P < .05). Moreover, among women with BIRADS 3, adjunctive ultrasonography detected no cancers. All 10 additional cancers detected by adjunctive ultrasonography were from women with BIRADS 0 to 2, at a cost of 207 women with false positives. Additionally, dense breasts and benign breast disease were significantly associated with positive ultrasonography after BIRADS 0 to 2 (all P values < .05). Conclusions: After negative mammography, adjunctive ultrasonography should only be recommended for BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease.

KW - Breast cancer

KW - Chinese women

KW - Mammography

KW - Screening

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=85028707286&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028707286&partnerID=8YFLogxK

U2 - 10.1016/j.clbc.2017.07.014

DO - 10.1016/j.clbc.2017.07.014

M3 - Article

JO - Clinical Breast Cancer

JF - Clinical Breast Cancer

SN - 1526-8209

ER -