Impact of breast size and composition on the accuracy of mammography and ultrasonography in breast cancer screening.

IF 4 3区医学 Q1 OBSTETRICS & GYNECOLOGY Breast Cancer Pub Date : 2025-01-02 DOI:10.1007/s12282-024-01664-5

Akira Nakamura, Koji Ohnuki, Haruka Takahashi, Shin Usami, Yuki Ishida, Setsuko Shibata, Akiko Umemura, Atsushi Kano

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Abstract

Background: The accuracy of mammography in breast cancer screening is influenced by different factors such as breast composition. However, previous studies did not evaluate the impact of breast size on examination accuracy. This study aimed to investigate the influence of breast size on the accuracy of mammography and ultrasonography in breast cancer screening using compressed breast thickness (CBT) on mammography as an indicator of breast size.

Methods: This study included Japanese women in their 40 s who underwent mammography alone (MG group) or mammography with adjunctive ultrasonography (MG + US group) at the Iwate Cancer Society (Iwate, Japan) in 2018 and 2019. Based on CBT, the participants were further divided into the L group (< 30 mm) and U group (≥ 30 mm). The recall rate, cancer detection rate, and positive predictive value of the L and U groups based on screening method and breast size were evaluated.

Results: Of 15,897 patients, 10,162 and 5735 underwent mammography alone and mammography with adjunctive ultrasonography, respectively. In the L group, the MG and MG + US groups did not significantly differ in terms of recall rate (1.9%, 95% CI 1.4-2.6 vs 1.9%, 1.2-2.9; p = 0.972). Moreover, the MG + US group had a higher cancer detection rate than the MG group. However, the difference was not significant (0.20%, 0.05-0.51 vs 0.63%, 0.25-1.29; p = 0.054). In the U group, the MG + US group had a significantly higher recall rate than the MG group (2.2%, 1.9-2.5 vs 2.9%, 2.5-3.4; p < 0.05). Nevertheless, there was no significant difference in the cancer detection rate (0.15%, 0.08-0.25 vs 0.28%, 0.15-0.48; p = 0.099).

Conclusions: To the best of our knowledge, this study first showed that breast size, in addition to breast composition, influences the accuracy of mammography and ultrasonography in breast cancer screening. Hence, screening methods tailored to individual breast characteristics should be considered.

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乳房大小和组成对乳腺x线摄影和超声检查乳腺癌筛查准确性的影响。

背景：乳房x线摄影在乳腺癌筛查中的准确性受到乳房组成等不同因素的影响。然而，以前的研究并没有评估乳房大小对检查准确性的影响。本研究旨在探讨乳腺尺寸对乳腺x线摄影和超声筛查乳腺癌准确性的影响，以压缩乳腺厚度（CBT）作为乳腺尺寸的指标。方法：本研究纳入了2018年和2019年在岩手癌症协会（日本岩手）接受单独乳房x光检查（MG组）或乳房x光检查与辅助超声检查（MG + US组）的40多岁日本女性。基于CBT，将参与者进一步分为L组(结果：15,897例患者中，分别有10,162例和5735例患者接受了乳房x光检查和辅助超声检查。在L组中，MG组和MG + US组在召回率方面没有显著差异(1.9%,95% CI 1.4-2.6 vs 1.9%, 1.2-2.9；p = 0.972)。MG + US组的肿瘤检出率高于MG组。但差异不显著(0.20%,0.05-0.51 vs 0.63%, 0.25-1.29；p = 0.054)。在U组中，MG + US组的召回率显著高于MG组(2.2%,1.9-2.5 vs 2.9%, 2.5-3.4；p结论：据我们所知，本研究首次表明，除了乳房成分外，乳房大小也会影响乳房x光检查和超声检查在乳腺癌筛查中的准确性。因此，应该考虑针对个体乳房特征的筛查方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer ONCOLOGY-OBSTETRICS & GYNECOLOGY

CiteScore

6.70

自引率

2.50%

发文量

105

审稿时长

6-12 weeks

期刊介绍： Breast Cancer, the official journal of the Japanese Breast Cancer Society, publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research, seeking to develop a new focus and new perspectives for all who are concerned with breast cancer. The journal welcomes all original articles describing clinical and epidemiological studies and laboratory investigations regarding breast cancer and related diseases. The journal will consider five types of articles: editorials, review articles, original articles, case reports, and rapid communications. Although editorials and review articles will principally be solicited by the editors, they can also be submitted for peer review, as in the case of original articles. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.