nach oben

Erschienen in:

29.03.2021 | Breast

Automated breast US as the primary screening test for breast cancer among East Asian women aged 40–49 years: a multicenter prospective study

verfasst von: Woo Jung Choi, Sung Hun Kim, Hee Jung Shin, Minseo Bang, Bong Joo Kang, Su Hyun Lee, Jung Min Chang, Woo Kyung Moon, Kyoungkyg Bae, Hak Hee Kim

Erschienen in: European Radiology | Ausgabe 10/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To prospectively evaluate the diagnostic performance of screening ABUS as the primary screening test for breast cancer among Korean women aged 40–49 years.

Methods

This prospective, multicenter study included asymptomatic Korean women aged 40–49 years from three academic centers between February 2017 and October 2019. Each participant underwent ABUS without mammography, and the ABUS images were interpreted at each hospital with double-reading by two breast radiologists. Biopsy and at least 1 year of follow-up was considered the reference standard. Diagnostic performance of ABUS screening and subgroup analyses according to patient and tumor characteristics were evaluated.

Results

Reference standard data were available for 959 women. The recall rate was 9.8% (95% confidence interval [CI]: 7.9%, 11.7%; 94 of 959 women) and the cancer detection yield was 5.2 per 1000 women (95% CI: −0.6, 11.1; 5 of 959 women). There was only one interval cancer. The sensitivity was 83.3% (95% CI: 53.5%, 100%; 5 of 6 cancers) and the specificity was 90.7% (95% CI: 88.8%, 92.5%; 864 of 95. women). The positive predictive values of biopsies performed (PPV₃) was 20.0% (95% CI: 4.3%, 35.7%; 5 of 25 women). Women with heterogeneous background echotexture had a higher recall rate (p = .009) and lower specificity (p = .036). Women with body mass index values < 25 kg/m² had a higher mean recall rate (p = .046).

Conclusion

In East Asia, screening automated breast US may be an alternative to screening mammography for detecting breast cancers in women aged 40–49 years.

Key Points

• Automated breast US screening for breast cancer in asymptomatic women aged 40–49 is effective with 5.2 per 1000 cancer detection yield.

• Women with heterogeneous background echotexture had a higher recall rate and lower specificity.

• Women with body mass index < 25 kg/m ² had a higher recall rate.

Nur mit Berechtigung zugänglich

Global Cancer Observatory (2020) Cancer fact sheets: breast (C50). International Agency for Research Cancer, Lyon, France. Available via https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf. Accessed 22 Jan 2021

Yap YS, Lu YS, Tamura K et al (2019) Insights into breast cancer in the East vs the West: a review. JAMA Oncol 5:1489–1496. https://doi.org/10.1001/jamaoncol.2019.0620CrossRefPubMed

Leong SP, Shen ZZ, Liu TJ et al (2010) Is breast cancer the same disease in Asian and Western countries? World J Surg 34:2308–2324. https://doi.org/10.1007/s00268-010-0683-1CrossRefPubMedPubMedCentral

Rajaram N, Mariapun S, Eriksson M et al (2017) Differences in mammographic density between Asian and Caucasian populations: a comparative analysis. Breast Cancer Res Treat 161:353–362. https://doi.org/10.1007/s10549-016-4054-yCrossRefPubMed

Niell BL, Freer PE, Weinfurtner RJ, Arleo EK, Drukteinis JS (2017) Screening for breast cancer. Radiol Clin North Am 55:1145–1162. https://doi.org/10.1016/j.rcl.2017.06.004CrossRefPubMed

Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L (2009) Screening for breast cancer: an update for the U.S. preventive services task force. Ann Intern Med 151(727-737):W237–W242. https://doi.org/10.7326/0003-4819-151-10-200911170-00009CrossRef

Kim YJ, Lee EH, Jun JK et al (2017) Analysis of participant factors that affect the diagnostic performance of screening mammography: a report of the Alliance for Breast Cancer Screening in Korea. Korean J Radiol 18:624–631. https://doi.org/10.3348/kjr.2017.18.4.624CrossRefPubMedPubMedCentral

Berg WA, Bandos AI, Mendelson EB, Lehrer D, Jong RA, Pisano ED (2016) Ultrasound as the primary screening test for breast cancer: analysis from ACRIN 6666. J Natl Cancer Inst 108:djv367. https://doi.org/10.1093/jnci/djv367CrossRefPubMed

Huang Y, Dai H, Song F et al (2016) Preliminary effectiveness of breast cancer screening among 1.22 million Chinese females and different cancer patterns between urban and rural women. Sci Rep 6:39459. https://doi.org/10.1038/srep39459CrossRefPubMedPubMedCentral

10.

Sood R, Rositch AF, Shakoor D et al (2019) Ultrasound for breast cancer detection globally: a systematic review and meta-analysis. J Glob Oncol 5:1–17. https://doi.org/10.1200/JGO.19.00127CrossRefPubMed

11.

Huang Y, Tong Z, Chen K et al (2019) Interpretation of breast cancer screening guideline for Chinese women. Cancer Biol Med 16:825–835. https://doi.org/10.20892/j.issn.2095-3941.2019.0322CrossRefPubMedPubMedCentral

12.

Ohuchi N, Suzuki A, Sobue T et al (2016) Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomised controlled trial. Lancet 387:341–348. https://doi.org/10.1016/S0140-6736(15)00774-6CrossRefPubMed

13.

Won SY, Park HS, Kim EK et al (2020) Survival rates of breast cancer patients aged 40 to 49 years according to detection modality in Korea: screening ultrasound versus mammography. Korean J Radiol. https://doi.org/10.3348/kjr.2019.0588

14.

van Zelst JCM, Mann RM (2018) Automated three-dimensional breast US for screening: technique, artifacts, and lesion characterization. Radiographics 38:663–683. https://doi.org/10.1148/rg.2018170162CrossRefPubMed

15.

Jia M, Lin X, Zhou X et al (2020) Diagnostic performance of automated breast ultrasound and handheld ultrasound in women with dense breasts. Breast Cancer Res Treat 181:589–597. https://doi.org/10.1007/s10549-020-05625-2CrossRefPubMed

16.

Zhang X, Chen J, Zhou Y et al (2019) Diagnostic value of an automated breast volume scanner compared with a hand-held ultrasound: a meta-analysis. Gland Surg 8:698–711. https://doi.org/10.21037/gs.2019.11.18CrossRefPubMedPubMedCentral

17.

Vourtsis A, Kachulis A (2018) The performance of 3D ABUS versus HHUS in the visualisation and BI-RADS characterisation of breast lesions in a large cohort of 1,886 women. Eur Radiol 28:592–601. https://doi.org/10.1007/s00330-017-5011-9CrossRefPubMed

18.

Brem RF, Tabár L, Duffy SW et al (2015) Assessing improvement in detection of breast cancer with three-dimensional automated breast US in women with dense breast tissue: the SomoInsight Study. Radiology 274:663–673. https://doi.org/10.1148/radiol.14132832CrossRefPubMed

19.

Giuliano V, Giuliano C (2013) Improved breast cancer detection in asymptomatic women using 3D-automated breast ultrasound in mammographically dense breasts. Clin Imaging 37:480–486. https://doi.org/10.1016/j.clinimag.2012.09.018CrossRefPubMed

20.

Kelly KM, Dean J, Comulada WS, Lee SJ (2010) Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts. Eur Radiol 20:734–742. https://doi.org/10.1007/s00330-009-1588-yCrossRefPubMed

21.

Wilczek B, Wilczek HE, Rasouliyan L, Leifland K (2016) Adding 3D automated breast ultrasound to mammography screening in women with heterogeneously and extremely dense breasts: report from a hospital-based, high-volume, single-center breast cancer screening program. Eur J Radiol 85:1554–1563. https://doi.org/10.1016/j.ejrad.2016.06.004CrossRefPubMed

22.

Ministry of Health and Welfare (2019) Number of cancer occurrence, incidence rate of 61 cancer types/sex/age. KOSIS, Daejeon, Republic of Korea. Available via https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117N_A0024&vw_cd=MT_ZTITLE&list_id=F_35&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=MT_ZTITLE). Accessed 22 Jan 2021

23.

Kim SH, Kim HH, Moon WK (2020) Automated breast ultrasound screening for dense breasts. Korean J Radiol 21:15–24. https://doi.org/10.3348/kjr.2019.0176CrossRefPubMed

24.

Kim WH, Moon WK, Kim SJ et al (2013) Ultrasonographic assessment of breast density. Breast Cancer Res Treat 138:851–859. https://doi.org/10.1007/s10549-013-2506-1CrossRefPubMed

25.

Lee EH, Kim KW, Kim YJ et al (2016) Performance of screening mammography: a report of the alliance for breast cancer screening in Korea. Korean J Radiol 17:489–496. https://doi.org/10.3348/kjr.2016.17.4.489CrossRefPubMedPubMedCentral

26.

Hong S, Song SY, Park B et al (2020) Effect of digital mammography for breast cancer screening: a comparative study of more than 8 million Korean women. Radiology 294:247–255. https://doi.org/10.1148/radiol.2019190951CrossRefPubMed

27.

Lee M, Mariapun S, Rajaram N, Teo SH, Yip CH (2017) Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country. BMC Public Health 17:127. https://doi.org/10.1186/s12889-017-4015-3CrossRefPubMedPubMedCentral

28.

Kim WH, Lee SH, Chang JM, Cho N, Moon WK (2017) Background echotexture classification in breast ultrasound: inter-observer agreement study. Acta Radiol 58:1427–1433. https://doi.org/10.1177/0284185117695665CrossRefPubMed

29.

Berg WA, Blume JD, Cormack JB et al (2008) Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 299:2151–2163. https://doi.org/10.1001/jama.299.18.2151CrossRefPubMedPubMedCentral

30.

Corsetti V, Houssami N, Ferrari A et al (2008) Breast screening with ultrasound in women with mammography-negative dense breasts: evidence on incremental cancer detection and false positives, and associated cost. Eur J Cancer 44:539–544. https://doi.org/10.1016/j.ejca.2008.01.009CrossRefPubMed

31.

Giger ML, Inciardi MF, Edwards A et al (2016) Automated breast ultrasound in breast cancer screening of women with dense breasts: reader study of mammography-negative and mammography-positive cancers. AJR Am J Roentgenol 206:1341–1350. https://doi.org/10.2214/AJR.15.15367CrossRefPubMed

32.

Chae EY, Kim HH, Cha JH, Shin HJ, Kim H (2013) Evaluation of screening whole-breast sonography as a supplemental tool in conjunction with mammography in women with dense breasts. J Ultrasound Med 32:1573–1578. https://doi.org/10.7863/ultra.32.9.1573CrossRefPubMed

33.

Mann RM, Hooley R, Barr RG, Moy L (2020) Novel approaches to screening for breast cancer. Radiology. https://doi.org/10.1148/radiol.2020200172

34.

Yang S, Gao X, Liu L et al (2019) Performance and reading time of automated breast US with or without computer-aided detection. Radiology 292:540–549. https://doi.org/10.1148/radiol.2019181816CrossRefPubMed

35.

van Zelst JCM, Tan T, Clauser P et al (2018) Dedicated computer-aided detection software for automated 3D breast ultrasound; an efficient tool for the radiologist in supplemental screening of women with dense breasts. Eur Radiol 28:2996–3006. https://doi.org/10.1007/s00330-017-5280-3CrossRefPubMedPubMedCentral

Titel: Automated breast US as the primary screening test for breast cancer among East Asian women aged 40–49 years: a multicenter prospective study
verfasst von: Woo Jung Choi
Sung Hun Kim
Hee Jung Shin
Minseo Bang
Bong Joo Kang
Su Hyun Lee
Jung Min Chang
Woo Kyung Moon
Kyoungkyg Bae
Hak Hee Kim
Publikationsdatum: 29.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-07864-3

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Automated breast US as the primary screening test for breast cancer among East Asian women aged 40–49 years: a multicenter prospective study