D Zhang, R Zhou, Y Dao, K Xue, R Zheng, J Wu, Y Xie, X Zhang, Z Li
For dense breasts, the BMRI-FDP showed the best efficacy in diagnosing early breast cancer, followed by BMRI-AP, then DBT and finally FFDM. FFDM, DBT, BMRI-AP and BMRI-FDP performed equally well in non-dense breasts. Although the diagnostic effects of BMRI-AP and BMRI-FDP were comparable, there was still a possibility of missing some lesions that had regular shapes and early enhancement features but do not exhibit rapid enhancement. However, the proportion of such cases was very small (0.83% in this study).
AIM: The aim of the study is to compare the detection performance of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), breast magnetic resonance imaging protocol (BMRI-AP) and BMRI-full diagnostic protocol (FDP) for early breast cancer in different breast density types.
MATERIALS AND METHODS: Based on the pathological results, the receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of different examination methods for breast cancer.
RESULTS: For dense breasts, the accuracy, sensitivity, and specificity of FFDM, DBT, BMRI-AP, and BMRI-FDP were, respectively, 82.7%, 88.9%, 94.1%, and 94.5% (P < 0.05); 83.0%, 89.8%, 94.2%, and 94.7% (P < 0.05); and 81.9%, 86.8%, 94.0%, and 94.0% (P < 0.05). The area under the curve (AUC) values for diagnosing early-stage breast cancer were 0.825, 0.883, 0.941, and 0.943, and there was no statistically significant difference between BMRI-AP and BMRI-FDP (P < 0.05). The AUC values for diagnosing early-stage breast cancer with BMRI-AP and BMRI-FDP were greater than those of FFDM and DBT (P < 0.05); the AUC for diagnosing early-stage breast cancer with DBT was greater than that of FFDM (P < 0.05). For nondense breasts, BMRI-FDP had the highest accuracy, at 95.0%, and sensitivity, at 94.1%. FFDM, DBT, and BMRI-AP showed equal performance (accuracy: 92.5%, sensitivity: 91.2%).
CONCLUSION: For dense breasts, the BMRI-FDP showed the best efficacy in diagnosing early breast cancer, followed by BMRI-AP, then DBT and finally FFDM. FFDM, DBT, BMRI-AP and BMRI-FDP performed equally well in non-dense breasts. Although the diagnostic effects of BMRI-AP and BMRI-FDP were comparable, there was still a possibility of missing some lesions that had regular shapes and early enhancement features but do not exhibit rapid enhancement. However, the proportion of such cases was very small (0.83% in this study).