Diagnostic performances of supplemental breast ultrasound screening in women with personal history of breast cancer

Abstract

Background

Supplemental breast ultrasonography (US) has been used as a surveillance imaging method in women with personal history of breast cancer (PHBC). However, there have been limited data regarding diagnostic performances.

Purpose

To evaluate diagnostic performances of supplemental breast US screening for women with PHBC and to compare with those for women without PHBC.

Material and Methods

Between 2011 and 2012, 12,230 supplemental US exams were performed in 12,230 women with negative mammograms: 6584 women with PHBC and 5646 women without PHBC. Cancer detection rate, interval cancer rate, abnormal interpretation rate, positive predictive values (PPVs), sensitivity, and specificity were calculated and compared.

Results

Overall cancer detection rate and first-year interval cancer rate were 1.80/1000 exams and 0.91/1000 negative exams, both of which were higher in women with PHBC than in women without PHBC (2.88 vs. 0.53 per 1000, P = 0.003; 1.50 vs. 0.20 per 1000, P = 0.027). Abnormal interpretation rate was lower in the women with PHBC than in women without PHBC (9.1% vs. 12.1%, P < 0.001). Sensitivity was not different (67.9% vs. 75.0%, P = 1.000), whereas specificity and PPV₃ were higher in women with PHBC than in women without PHBC (91.2% vs. 88.0%, P < 0.001; 22.6% vs. 3.1%, P < 0.001). The majority of detected cancers in women with PHBC (78.9%, 15/19) were stage 0 or 1.

Conclusion

Supplemental breast US screening increases early stage second breast cancers with high specificity and PPV₃ in women with PHBC, however, high interval cancer rate in younger women with PHBC should be noted.

Keywords

Ultrasonography breast neoplasm risk outcome assessment sensitivity and specificity

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