Enhanced Detection of Suspicious Breast Lesions: A Comparative Study of Full-Field Digital Mammography and Automated Breast Ultrasound in 117 Patients with Core Needle Biopsy.

Marta Pawlak, Wojciech Rudnicki, Łukasz Brandt, Małgorzata Dobrowolska, Anna Borkowska, Joanna Szpor, Elżbieta Łuczyńska
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Abstract

BACKGROUND This retrospective study from a single center aimed to compare the performance of full-field digital mammography (FFDM) vs automated breast ultrasound (ABUS) in the identification and characterization of suspicious breast lesions in 117 patients who underwent core-needle biopsy (CNB) of the breast. MATERIAL AND METHODS The study involved a group of 301 women. Every patient underwent FFDM followed by ABUS, which were assessed in concordance with BI-RADS (Breast Imaging Reporting and Data System) classification. RESULTS No focal lesions were found in 168 patients. In 133 patients, 117 histopathologically verified focal lesions were found. Among them, 78% appeared to be malignant and 22% benign. ABUS detected 246 focal lesions, including 115 classified as BI-RADS 4 or 5 and submitted to verification, while FFDM revealed 122 lesions, including 75 submitted to verification. The analysis revealed that combined application of both methods caused sensitivity to increase to 100, and improved accuracy improvement. Margin assessments in these examinations are consistent (P<0.00), the lesion's margin type with both methods depends on its malignant or benign character (P<0.03), lesion margins distribution on ABUS depends on estrogen receptor presence (P=0.033), and there was significant correlation between malignant character of the lesion and retraction phenomenon sign (P=0.033). ABUS obtained higher compliance between the size of the lesion in histopathology compared to FFDM (P>0.05). CONCLUSIONS The results shows that ABUS is comparable to FFDM, and even outperforms it in a few of the analyzed categories, suggesting that the combination of these 2 methods may have an important role in breast cancer detection.

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增强乳房可疑病变的检测:117例核心穿刺活检患者全视野数字乳房x线摄影与自动乳房超声的比较研究。
背景:本回顾性研究旨在比较117例接受核心穿刺活检(CNB)的患者,全视野数字乳房x线摄影(FFDM)与自动乳房超声(ABUS)在识别和表征可疑乳房病变方面的表现。材料和方法该研究涉及301名妇女。每位患者均行FFDM后ABUS,并按照BI-RADS(乳腺成像报告和数据系统)分类进行评估。结果168例患者未发现局灶性病变。在133例患者中,发现117例经组织病理学证实的局灶性病变。其中78%为恶性,22%为良性。ABUS检测到246个局灶性病变,其中115个归为BI-RADS 4级或5级并提交验证,而FFDM显示122个病变,其中75个提交验证。分析表明,两种方法的联合应用使灵敏度提高到100,并提高了精度。这些检查的切缘评估是一致的(P0.05)。结论ABUS与FFDM相当,甚至在部分分析类别中优于FFDM,提示两种方法联合应用可能在乳腺癌检测中发挥重要作用。
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