Comparison of the diagnostic efficiency for breast cancer in
Chinese women using mammography, ultrasound, MRI, and different combinations of
these imaging modalities
Abstract: To compare the respective diagnostic efficiency for breast cancer in
Chinese women with x-ray mammography (XRM), ultrasound (US), magnetic resonance
imaging (MRI; standard dynamic contrasted-enhanced MRI with diffusion-weighted
imaging), and different combinations of these imaging modalities, ninety
Chinese women patients with clinically suspected breast cancer underwent
prospective breast XRM, US, and MRI. The diagnostic performance of each imaging
method and different combinations of methods was compared, with the
pathological report serving as the gold standard. In this cohort study 54.4%
cases with age of 53.2 ± 7.6 years old were categorized as ACR 3 or 4
tissue density. In the diagnosis of breast cancer, sensitivity and diagnostic
accuracy [area under the Receiver Operating Characteristic curve (AUC)] were
significantly higher for MRI alone than for either XRM alone or US alone (P<
0.05). Of the misdiagnosed cases on XRM, up to 86.7% cancers were located in
dense breasts. US and MRI can play important role in screening young Chinese
women. The diagnostic sensitivity was significantly higher for combined
MRI+US+XRM (98.2%, χ^2=25.9, P< 0.001), MRI+US
(94.5%, χ^ 2 53.3, P=0.002) and MRI+XRM (92.9%
combination of two or three methods significantly improved the diagnostic
sensitivity for breast cancer in Chinese women. When the results based on
different imaging modalities or their combinations are inconsistent, further
pathological diagnosis is very important for arriving at a correct diagnosis.
Keywords: Breast cancer, magnetic resonance imaging, ultrasound, X-ray mammography, diagnosis
