Evaluation Of The Diagnostic Efficiency Of Mammography,Ultrasonography And Contrast-Enhanced Magnetic Resonance Imaging For Breast Diseases In Women Aged 35 Years Or Below

Objective: To evaluate the diagnostic efficiency of mammography,ultrasonography and dynamic contrast enhancement magnetic resonance imaging(DCE-MRI)for breast diseases by analyzing retrospectively these images from young women(aged ?35 years)with pathologically documented breast diseases.Materials and Methods: Sixty-one young women(aged 25-35 years)who were pathologically confirmed with breast diseases in the hospital from February 2012 to May 2017 were collected;among them,23 were with breast cancer,including 20 with invasive ductal carcinoma,1 with intraductal carcinoma,1 with mucinous carcinoma,and 1 with intraductal papillary carcinoma;38 were with benign diseases,including 28 with breast hyperplastic diseases,and 10 with mastitis.All the patients had undergone mammography,ultrasonography and DCE-MRI within 2 weeks prior to surgery,and were classified based on the diagnostic classification in American College of Radiology(ACR)Breast Imaging-Reporting and Data System(BI-RADS?)2013.The manifestations of each breast disease in each imaging examination were analyzed retrospectively,and the diagnostic efficiency of each examination for breast diseases was evaluated by calculating the 6 indicators for diagnostic efficiency.Results: Breast cancer in young women was primarily invasive ductal carcinoma(20/23,87.0%),and the majority of them were of higher grade(grade II/III in 16/20 patients,80.0%);the mammography were primarily poorly defined,irregular masses with increased opacity(with calcification)(14/23,60.9%).The sensitivity,specificity,positive predictive value,and negative predictive value were mammography: 87.0%,71.1%,64.5%,and 90.0%,respectively;ultrasonography: 95.7%,76.3%,68.8%,and 96.7%,respectively;and DCE-MRI: 100%,88.2%,85.2%,and 100%,respectively.There was statistically significant difference between DCE-MRI and mammography(Z=2.264,P=0.0236),and no statistically significant difference between ultrasonography and DCE-MRI in area under the receiver operating characteristic curve(AUC).Conclusion: For breast diseases in women aged 35 years or below,ultrasonography could serve as a primary diagnostic method for breast diseases in young women,particularly those with heterogeneously dense breasts;in case of clinically suspicious malignancy,diagnosis should be made in combination with DCE-MRI,so as to enhance the accuracy of early diagnosis of breast cancer,Mammography is not recommended as the first choice for suspicious breast cancer among young women.