A Comparison of Mammography and Ultrasound in Women with Breast Disease: A Receiver Operating Characteristic Analysis

The Breast Journal, 03/06/2012

The diagnostic accuracy of diagnostic sonography was significantly better than that of mammography among patients <50 years of age and premenopausal or perimenopausal patients. The combination of mammography and sonography increased the sensitivity and diagnostic accuracy.

Methods

  • From 1999 to 2007, 549 patients underwent 665 examination sessions (mammography and ultrasound).
  • Abnormalities were deemed positive if biopsy findings revealed malignancy and negative if findings from biopsy or all screening examinations were negative.
  • On pathology, 246 lesions were malignant and 419 were benign in the 549 patients.
  • The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC) of mammography and sonography were 81.71% and 95.53%, 85.44% and 80.43%, 76.72% and 74.13%, 88.83% and 96.84%, and 0.886 and 0.948, respectively.
  • The sensitivity and diagnostic accuracy among patients <50 years of age were significantly higher for sonography than for mammography (p < 0.05).
  • The sensitivity and diagnostic accuracy among premenopausal or perimenopausal patients were significantly higher for sonography than for mammography (p < 0.05).

Results

  • The sensitivity among postmenopausal patients was significantly higher for sonography than for mammography (p < 0.05).
  • The results of combined mammography and sonography were classified using American College of Radiology Breast Imaging Reporting and Data System (BI–RADS).
  • There were 244 positive and two negative examinations of malignant lesions, and 106 positive and 313 negative examinations of benign lesions.
  • The diagnostic accuracy of the combination was significantly higher than that of mammography (p < 0.05) and similar to that of sonography (p > 0.05).
  • Sonography had better sensitivity and diagnostic accuracy than mammography for diagnosing breast diseases, while their specificities were similar.

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