Evaluation of Screening US-detected Breast Masses by Combined Use of Elastography and Color Doppler US with B-Mode US in Women with Dense Breasts: A Multicenter Prospective Study
- Authors
- Lee, Su Hyun; Chung, Jin; Choi, Hye Young; Choi, Seon Hyeong; Ryu, Eun Bi; Ko, Kyung Hee; Koo, Hye Ryoung; Park, Jeong Seon; Yi, Ann; Youk, Ji Hyun; Son, Eun Ju; Chu, A. Jung; Chang, Jung Min; Cho, Nariya; Jang, Myoung-jin; Kook, Shin Ho; Cha, Eun Suk; Moon, Woo Kyung
- Issue Date
- Nov-2017
- Publisher
- RADIOLOGICAL SOC NORTH AMERICA
- Citation
- RADIOLOGY, v.285, no.2, pp.660 - 669
- Indexed
- SCIE
SCOPUS
- Journal Title
- RADIOLOGY
- Volume
- 285
- Number
- 2
- Start Page
- 660
- End Page
- 669
- URI
- https://scholarworks.bwise.kr/gnu/handle/sw.gnu/13366
- DOI
- 10.1148/radiol.2017162424
- ISSN
- 0033-8419
- Abstract
- Purpose: To investigate the value of the combined use of elastography and color Doppler ultrasonography (US) with B-mode US for evaluation of screening US-detected breast masses in women with dense breasts. Materials and Methods: This prospective, multicenter study included asymptomatic women with dense breasts who were referred for screening US between November 2013 and December 2014. Eligible women had a newly detected breast mass at conventional B-mode US screening, for which elastography and color Doppler US were performed. The following outcome measures were compared between B-mode US and the combination of B-mode US, elastography, and color Doppler US: area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and the number of false-positive findings at screening US. Results: Among 1021 breast masses (mean size, 1.0 cm; range, 0.3-3.0 cm) in 1021 women (median age, 45 years), 68 were malignant (56 invasive). Addition of elastography and color Doppler US to B-mode US increased the AUC from 0.87 (95% confidence interval [CI]: 0.82, 0.91) to 0.96 (95% CI: 0.95, 0.98; P<001); specificity from 27.0% (95% CI: 24.2%, 29.9%) to 76.4% (95% CI: 73.6%, 79.1%; P<.001) without loss in sensitivity (95% CI: 21.5%, 1.5%; P>.999); and PPV from 8.9% (95% CI: 7.0%, 11.2%) to 23.2% (95% CI: 18.5%, 28.5%; P<.001), while avoiding 67.7% (471 of 696) of unnecessary biopsies for nonmalignant lesions. Conclusion: Addition of elastography and color Doppler US to B-mode US can increase the PPV of screening US in women with dense breasts while reducing the number of false-positive findings without missing cancers.
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