Effects of Age, Breast Density and Volume on Breast Cancer Diagnosis: A Retrospective Comparison of Sensitivity of Mammography and Ultrasonography in China's Rural Areas

Objective: To compare the mammogarphic appearance between breast cancer patients aged <40 and ≥40 years. Methods: Needle localization and biopsy of suspicious mammographic lesions identified 1,959 breast carcinomas in a single institution from Jun 2012 to Apr 2013. According to the age, we divided patients into two groups: <40 and ≥40 years old, and analyzed mammographic appearance separately. Results: Young patients had 44.2% foci with calcification, but old patients only had 39.4% (P<0.001). In younger group, the ratios of cases according to mass density were 41.8% or higher, 58.2% equivalent and lower. In older group, the ratios were 55.5 % and 44.5%, respectively. There were statistical differences between high density and others (P<0.05). The ratios of cases according to mass margin were 13.9% circumscribed and microlobulated, 86.1% indistinct and spiculated in the younger group, as compared to 6.5% and 93.5%, respectively, in the older group (P<0.05). Conclusions: Mammographic findings differ between young and old patients with breast cancer, for example regarding mass density, mass margin and microcalcification ratios.

Section: Discussionmentioning

confidence: 99%

Differences Between Breast Cancer Patients Younger and Older than 40 Years: Mammographic Findings

Wang

Liu

et al. 2014

“…Therefore, with regard to the Chinese women in younger than 55 years old, the addition of other modalities such as ultrasound may provide some potential benefits in the sensitivity, specificity as well as diagnostic accuracy of the detection and characterization of early stage breast cancer. A recent research (Wang et al, 2013) reported that ultrasonography was markedly more effective than mammography for most Chinese women who were younger than 55 years old. Recently, the State Legislatures of Connecticut, Texas, Virginia, California and New York passed laws requiring physicians to tell women whether they have dense tissue based on mammographic imaging.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Mammographic Breast Density in a Group of Screening Chinese Women and Breast Cancer Patients

Liu¹,

Liu²,

Li³

et al. 2014

Background: A dense breast not only reduces the sensitivity of mammography but also is a moderate independent risk factor for breast cancer. The percentage of Western women with fat breast tissue is higher aged 40 years or older. To a certain extent, mammography as a first choice of screening imaging method for Western women of this group is reasonable. Hitherto, the frequency and age distribution of mammographic breast density patterns among Chinese women had not been characterized. The purpose of this study was to investigate the frequency and age distribution of mammographic breast density patterns among a group of Chinese screening women and breast cancer patients in order to provide useful information for age-specific guidelines for breast cancer screening in Chinese women. Methods: A retrospective review of a total of 3,394 screening women between August and December 2009 and 2,527 breast cancer patients between July 2011 and June 2012 was conducted. Descriptive analyses were used to examine the association between age and breast density. The significance of differences of breast density between the screening women and the breast cancer patients was examined using nonparametric tests. Results: There was a significant inverse relationship between age and breast density overall (r=-0.37, p< 0.01). Breast density of the breast cancer patients in the subgroups of 40-49 years old was greater compared with that of the screening women, the same in those aged 50-54 years and in those 55 years old or older, less than in the screening group. Conclusions: With regard to the Chinese women younger than 55 years old, the diagnostic efficiency of breast cancer screening imaging examinations may be potentially improved by combining screening mammography with ultrasound.

“…Breast US is widely available, painless, well-tolerated, relatively inexpensive, and does not involve ionizing radiation (Berg et al, 2008). Supplemental screening using breast US increased the detection of early, node-negative, invasive breast cancers not normally seen on mammography in women with dense parenchyma (Benson et al, 2004;Berg et al, 2004;Wang et al, 2013). However, the dependence on operator technique for hand-held ultrasound (HHUS) is a major concern when considering the widespread use of whole-breast US (Akbari et al, 2012;Lin et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Automated Breast Volume Scanning and Hand-Held Ultrasound in the Detection of Breast Cancer: an Analysis of 5,566 Patient Evaluations

Choi¹,

Hee²,

Kim³

et al. 2014

Background: The purpose of this study was to compare the accuracy and effectiveness of automated breast volume scanning (ABVS) and hand-held ultrasound (HHUS) in the detection of breast cancer in a large population group with a long-term follow-up, and to investigate whether different ultrasound systems may influence the estimation of cancer detection. Materials and Methods: Institutional review board approval was obtained for this retrospective study, and informed consent was waived. From September 2010 to August 2011, a total of 1,866 ABVS and 3,700 HHUS participants, who underwent these procedures at our institute, were included in this study. Cancers occurring during the study and subsequent follow-up were evaluated. The reference standard was a combination of histology and follow-up imaging (≥12 months). The recall rate, cancer detection yield, diagnostic accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were calculated with exact 95% confidence intervals. Results: The recall rate was 2.57 per 1,000 (48/1,866) for ABVS and 3.57 per 1,000 (132/3,700) for HHUS, with а significant difference (p=0.048). The cancer detection yield was 3.8 per 1,000 for ABVS and 2.7 per 1,000 for HHUS. The diagnostic accuracy was 97.7% for ABVS and 96.5% for HHUS with statistical significance (p=0.018). The specificity of ABVS and HHUS were 97.8%, 96.7%, respectively (p=0.022). Conclusions: ABVS shows a comparable diagnostic performance to HHUS. ABVS is an effective supplemental tool for mammography in breast cancer detection in a large population.