Evaluation of Adjunctive Ultrasonography for Breast Cancer Detection Among Women Aged 40-49 Years With Varying Breast Density Undergoing Screening Mammography
| Autor: | Akihiko Suzuki, Ying-Fang Zheng, Yoko Narikawa-Shiono, Akiko Sato-Tadano, Takanori Ishida, Rie Ohta, Narumi Harada-Shoji, Noriaki Ohuchi |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Breast Neoplasms Sensitivity and Specificity Asymptomatic law.invention Breast cancer screening Breast cancer Randomized controlled trial law medicine Humans Mammography Breast skin and connective tissue diseases Early Detection of Cancer Ultrasonography Original Investigation Breast Density medicine.diagnostic_test Obstetrics business.industry Research Cancer Secondary data General Medicine Middle Aged medicine.disease Data Accuracy Featured Clinical trial Online Only Oncology Practice Guidelines as Topic Female medicine.symptom business |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question Does the performance of adjunctive ultrasonography for breast cancer detection among women undergoing screening mammography change according to breast tissue density? Findings In this secondary analysis of a randomized clinical trial, screening mammography alone demonstrated low sensitivity, whereas adjunctive ultrasonography improved sensitivity both in dense and nondense breasts. Meaning These findings suggest that adjunctive ultrasonography has the potential to improve the detection of early-stage and invasive cancers across both dense and nondense breasts and to mitigate the flaws of mammographic screening. This secondary analysis of a randomized clinical trial evaluates the performance of adjunctive ultrasonography for breast cancer screening in asymptomatic women aged 40 to 49 years undergoing screening mammography according to differences in breast density. Importance Mammography has limited accuracy in breast cancer screening. Ultrasonography, when used in conjunction with mammography screening, is helpful to detect early-stage and invasive cancers for asymptomatic women with dense and nondense breasts. Objective To evaluate the performance of adjunctive ultrasonography with mammography for breast cancer screening, according to differences in breast density. Design, Setting, and Participants This study is a secondary analysis of the Japan Strategic Anti-cancer Randomized Trial. Between July 2007 and March 2011, asymptomatic women aged 40 to 49 years were enrolled in Japan. The present study used data from cases enrolled from the screening center in Miyagi prefecture during 2007 to 2020. Participants were randomly assigned in a 1:1 ratio to undergo either mammography with ultrasonography (intervention group) or mammography alone (control group). Data analysis was performed from February to March 2020. Exposures Ultrasonography adjunctive to mammography for breast cancer screening regardless of breast density. Main Outcomes and Measures Sensitivity, specificity, recall rates, biopsy rates, and characteristics of screen-detected cancers and interval breast cancers were evaluated between study groups and for each modality according to breast density. Results A total of 76 119 women were enrolled, and data for 19 213 women (mean [SD] age, 44.5 [2.8] years) from the Miyagi prefecture were analyzed; 9705 were randomized to the intervention group and 9508 were randomized to the control group. A total of 11 390 women (59.3%) had heterogeneously or extremely dense breasts. Among the overall group, 130 cancers were found. Sensitivity was significantly higher in the intervention group than the control group (93.2% [95% CI, 87.4%-99.0%] vs 66.7% [95% CI, 54.4%-78.9%]; P |
| Databáze: | OpenAIRE |
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