| Department one The Comparison among Ultrasound,Mammography and MRI on Diagnosing Breast CancersPart ? The Diagnostic value of Ultrasound,Mammography and MRI for Breast CancerObjective: To compare the diagnostic value of Ultrasound,Mammography and MRI.Mothed: The research analyzed 695 patients with 811 lesions which were checked by Ultrasound,Mammography and MRI.All the lesions were confirmed by pathology after surgery or biopsy.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were compared among Ultrasound,Mammography and MRI.The diagnostic value of Ultrasound,Mammography and MRI was assessed by Area under the Curve(AUC)of Receiver Operating Characteristic(ROC)curves.Result: 1.the sensitivity of Ultrasound,Mammography,MRI was 84.4%,66.6%,92.4%,respectively,and there was no significant difference among them(P<0.05).2.The specificity of mammography was significantly higher than Ultrasound and MRI(97.1% vs 92.1%,89.3%,P <0.001).3.The accuracy of MRI was significantly higher than Mammography(90.3% vs 86.1%,P= 0.009),and the difference between MRI and Ultrasound was statistically significant(90.3% vs 89.3%,P=0.521).The rate of Mammographic missed diagnosis and misdiagnosis for breast cancer was significantly higher than Ultrasound and MRI(P<0.05)?5.The area under the ROC curve of Ultrasound,Mammography and MRI was 0.916,0.852 and 0.955 respectively,and the difference was statistically significant(P <0.001).Part ? Analysis of Diagnostic Efficacy of Mammography for Breast CancerObjective: To compare the different breast imaging examination for the breast cancer with positive mammography.Methods: A total of 438 positive mammographic patients with 506 lesions were retrospectively analyzed.The lesions were confirmed by surgery or biopsy.The lesions were analyzed by the different category of mammographic findings(calcification and mass like).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Mammography in diagnosing breast cancer were compared with those of Ultrasound and MRI.Results: 1.The detection rate of Ultrasonography,Mammography and MRI was 92.8%(753/811),62.4%(506/811),98.6%(800/811)respectively,and the difference among the three methods were was statistically significant(P <0.001).2.The sensitivity of Mammography in the diagnosis of calcified breast cancer and mass like cancer was significantly higher than that in Mammographic positive breast cancer(92.7%,86.2% vs 77.5%,P <0.05).3.The specificity of Mammography diagnosis of calcified breast cancer was lower than that of Mammographic positive breast cancer and mass like cancer(89.7% vs 94.2% and 95.1%,P <0.05).4.The accuracy of Mammography diagnosis of calcified and mass like breast cancer was significantly higher than that of Mammographic positive breast cancer(91.7% vs 85.9%,90.9%,P <0.05).Conclusion:The missed diagnosis rate and misdiagnosis rate of Mammography was significantly higher than Ultrasound and MRI,and the overall accuracy of breast cancer diagnosis was significantly lower than Ultrasound and MRI,but Mammography possesses high value for calcified and mass like cancer.Department Two Comparison of Detection Rate of Breast Lesions by Ultrasound,Mammography and MRIObjective: To compare the detection rate of breast lesions with Ultrasound,Mammography and MRI,and to analyze the detection factors.Methods: A total of 811 lesions of 695 breast patients were analyzed retrospectively.BI-RADS 1 category was defined as undetected lesion,BI-RADS 2~5 category as the detected lesions,and all the esions were confirmed by surgery or biopsy.The overall detection of breast lesions by Ultrasound,Mammography and MRI was compared.Whether the different age,glandular density,diameter,tumor type and calcification affect the detection rate of Ultrasound,Mammography and MRI was analyzed.Results: 1.the detection rate of MRI was significantly higher than that Ultrasound and Mammography(98.6% vs 92.8%,62.4%,P <0.05),and was not affected by age,breast density,diameter,pathological type and tumor type.2.The detection rate of Mammography increased with patient's age and the diameter of breast mass(P <0.001).The detection rate of Mammography for dense breast was lower than non-dense breast(94.6% vs 57.3%,P<0.001).The detection rate of malignant lesions was significantly higher than that of benign lesions(85.9% vs 49.3%,P<0.001).There was no significant difference in the detection rate of different type of lesions.3.The detection rate of Ultrasound increased with the diameter of the lesion increasing(P=0.006).The detection rate of malignant lesions was significantly higher than that of benign lesions(95.9% vs 91.2%,P=0.013).The detection rate of mass like lesions was significantly higher than that of intraductal lesions(95.4% vs 85.6%,P <0.001).The detection rate of breast lesions by conventional ultrasound was not affected by the patient's age and breast density.4.Logistic regression analysis showed that the diameter and pathological type of the lesions were the main factors of Ultrasound and Mammography(P <0.05).Conclusion: 1.The Mammographic detection rate of breast lesions is affected by the patient's age,breast density,diameter and pathological type of the lesions,which for the older age group,non-dense breast,larger diameter and malignant lesions higher.2.The detection rate of breast lesions by Ultrasound was affected by lesion's diameter,lesion type and pathological type,and the detection rate of lesion and malignant lesion was higher.3.The rate of breast lesions by MRI was not affected by patient age,breast density,diameter,pathological type and lesion type.Department Three The Comparison of The Diagnostic Value between Ultrasound and MRI on Breast Cancer Non-detected at MammographyObjective: The aim of the research was to compare the diagnostic value of Ultrasound(US)and Magnetic Resonance Imaging(MRI)on lesions with negative Mammography(MG).Method: This study retrospectively analyzed 305 lesions from 257 MG-negative patients who nderwent US and MRI examination.All the cases were confirmed by pathology after surgery.The difference of the detection rate for MG-negative breast lesions and the diagnostic value for MG-negative breast cancer between US and MRI was analyzed.Result: The detection rate of MRI and US for all MG-negative lesions was 97.38% and 90.49%,respectively.MRI had the higher detection rate than US for intraductal lesions(98.21% vs 75.00%,P<0.05),and there was no significant difference between the two methods in the detection rate of mass like lesions(97.19% vs 93.98%,P>0.05).The sensitivity,specificity and accuracy of US and MRI in diagnosing breast cancer were 63.4%?93.9%?89.8% and 70.7%?91.3%?88.5%,respectively,and there was no significant difference between the two methods(P>0.05).The area under ROC curves of US and MRI was 0.800 and 0.745,respectively,and there was no significant difference between the two methods(P>0.05).Conclusion: Both US and MRI have a high detection rate of MG-negative breast lesions,and MRI is superior to US in detection of MG-negative introductal lesions.The diagnostic value of US on MGnegative breast cancer is similar to MRI,therefor,US should be the preferred method of examination.Department Four Comparison of Diagnostic Value of Ultrasound Combined with Mammography and MRI on Breast CancerObjective: To explore the diagnostic value of Ultrasound combined with Mammography in breast cancer and to compare it with MRI.Method: A total of 695 patients with 811 lesions were checked by Ultrasound,Mammography,and MRI.All the lesions were confirmed by pathology after surgery or biopsy.The detection rate of Ultrasound combined with Mammography and MRI was compared.breast lesions was calculated,and the difference between the two methods on the diagnosis of breast cancer sensitivity,specificity,positive predictive value,negative predictive value and accuracy was analyzed,then the ROC curve was used to compare the diagnostic value of two methods.Results: 1.The detection rate of breast lesions was significantly lower than that of MRI(96.3% vs 98.6%,P <0.05),and there was no significant difference between the two groups for breast malignant esions(98.6% Vs 99.7%,P> 0.05).2.There was no significant difference in the sensitivity,specificity,positive predictive value,negative predictive value and accuracy between the combination of Ultrasound and Mammography and MRI(89.3% vs 92.4%,89.3% vs 89.1%,82.5% vs 82.7%,93.6% vs 95.5%,89.3% vs 90.4%,P>0.05).3.The area under the ROC curve of Ultrasound combined with Mammography was not statistically significant different from MRI(0.894 vs 0.901,P>0.05).Conclusion: 1.the overall detection rate of Mammography was lower than MRI,but the detection rate of malignancy was not significantly different from MRI.The diagnostic value of Ultrasound combined with Mammography in breast cancer is similar to MRI.Ultrasound and Mammography are preferred methods for breast cancer screening and diagnosis.Breast cancer high risk patients can be further MRI examination. |
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