DOI QR코드

DOI QR Code

Effects of Age, Breast Density and Volume on Breast Cancer Diagnosis: A Retrospective Comparison of Sensitivity of Mammography and Ultrasonography in China's Rural Areas

  • Wang, Feng-Liang (Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University) ;
  • Chen, Fei (Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University) ;
  • Yin, Hong (Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University) ;
  • Xu, Nan (First Clinical Medicine College, Nanjing University of Chinese Medicine) ;
  • Wu, Xiao-Xiang (Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University) ;
  • Ma, Jing-Jing (Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University) ;
  • Gao, Shen (Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University) ;
  • Tang, Jin-Hai (Department of Breast Surgery, Jiangsu Cancer Hospital and Research Institute) ;
  • Lu, Cheng (Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University)
  • Published : 2013.04.30

Abstract

Purpose: Mammography has been confirmed as the only effective mode to improve the prognosis of patients with breast cancer in Western developed countries, but might not be a good choice in other areas of the world. One of the major challenges in China is to determine an optimal imaging modality for breast cancer screening. This study was designed to clarify the sensitivity of ultrasonography compared with that of mammography in rural China. Methods: We retrospectively studied the sensitivity of mammography and ultrasonography based on 306 breast cancer patients detected by the program of "screening for cervical cancer and breast cancer" performed in Chinese rural areas between January 2009 and December 2011, and analyzed the effects of age, breast density and volume on the sensitivity. Results: Stratified analysis showed that the sensitivity of breast ultrasonography was significantly higher than that of mammography in premenopausal patients (81.4% vs. 61.1%, p=0.02), in women ${\leq}$ 55 years of age (82.2% vs. 63.4%, p<0.01), in the high breast density group (American College of Radiology [ACR] levels 3-4) (85.9% vs. 60.6%, p<0.01) and in the small breast volume group (${\leq}$ 400 ml) (87.1% vs. 66.7%, p<0.01). Age had a significant effect on sensitivity of mammography (breast density and volume-adjusted odds ratio, 6.39; 95% confidence interval, 2.8-14.4 in age group > 55 compared to age group ${\leq}$ 45), but not that of ultrasonography. Neither breast density nor volume had significant effect on sensitivity of mammography or ultrasonography. Conclusions: Ultrasonography is more sensitive than mammography in detecting breast cancer in women under 55 year-old Chinese, especially in those with high-density and relatively small breasts.

Keywords

References

  1. Berg WA, Blume JD, Cormack JB, et al (2008). Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA, 299, 2151-63. https://doi.org/10.1001/jama.299.18.2151
  2. Birdwell RL (2009). The preponderance of evidence supports computer-aided detection for screening mammography. Radiology, 253, 9-16. https://doi.org/10.1148/radiol.2531090611
  3. Carney PA, Miglioretti DL, Yankaskas BC, et al (2003). Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Ann Intern Med, 138, 168-75. https://doi.org/10.7326/0003-4819-138-3-200302040-00008
  4. Cheng SH, Tsou MH, Liu MC, et al (2000). Unique features of breast cancer in Taiwan. Breast Cancer Res Treat, 63, 213-23. https://doi.org/10.1023/A:1006468514396
  5. D'Orsi CJ, Bassett LW, Berg WA, et al (2003). Breast Imaging Reporting and Data System, BI-RADS: Mammography. 4th ed. Reston, VA: American College of Radiology.
  6. Etzioni R, Urban N, Ramsey S, et al. (2003). The case for early detection. Nat Rev Cancer, 3, 243-52. https://doi.org/10.1038/nrc1041
  7. Fan L, Zheng Y, Yu KD, et al (2009). Breast cancer in a transitional society over 18 years: trends and present status in Shanghai, China. Breast Cancer Res Treat, 117, 409-16. https://doi.org/10.1007/s10549-008-0303-z
  8. Han JG, Jiang YD, Zhang CH, et al (2011). Clinicopathologic characteristics and prognosis of young patients with breast cancer. Breast, 20, 370-2. https://doi.org/10.1016/j.breast.2011.02.011
  9. Huang Y, Kang M, Li H, et al (2012). Combined performance of physical examination, mammography, and ultrasonography for breast cancer screening among Chinese women: a followup study. Curr Oncol, 19, eS22-30.
  10. Humphrey LL, Helfand M, Chan BK, et al (2002). Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med, 137, 347-60. https://doi.org/10.7326/0003-4819-137-5_Part_1-200209030-00012
  11. Jemal A, Siegel R, Xu J, et al (2010). Cancer statistics, 2010. CA Cancer J Clin, 60, 277-300. https://doi.org/10.3322/caac.20073
  12. Kalbhen CL, McGill JJ, Fendley PM, et al (1999). Mammographic determination of breast volume: comparing different methods. AJR Am J Roentgenol, 173, 1643-9. https://doi.org/10.2214/ajr.173.6.10584814
  13. Kang DK, Jeon GS, Yim H, et al (2007). Diagnosis of the intraductal component of invasive breast cancer: assessment with mammography and sonography. J Ultrasound Med, 26, 1587-600.
  14. Kayar R, Civelek S, Cobanoglu M, et al (2011). Five methods of breast volume measurement: a comparative study of measurements of specimen volume in 30 mastectomy cases. Breast Cancer (Auckl), 5, 43-52.
  15. Kuhl CK, Schrading S, Leutner CC, et al (2005). Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol, 23, 8469-76. https://doi.org/10.1200/JCO.2004.00.4960
  16. Lee CH, Dershaw DD, Kopans D, et al (2010). Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol, 7, 18-27. https://doi.org/10.1016/j.jacr.2009.09.022
  17. Lee SY, Jeong SH, Kim YN, et al (2009). Cost-effective mammography screening in Korea: high incidence of breast cancer in young women. Cancer Sci, 100, 1105-11. https://doi.org/10.1111/j.1349-7006.2009.01147.x
  18. Lehman CD, Lee CI, Loving VA, et al (2012). Accuracy and value of breast ultrasound for primary imaging evaluation of symptomatic women 30-39 years of age. AJR Am J Roentgenol, 199, 1169-77. https://doi.org/10.2214/AJR.12.8842
  19. Li J, Zhang BN, Fan JH, et al (2011). A nation-wide multicenter 10-year (1999-2008) retrospective clinical epidemiological study of female breast cancer in China. BMC Cancer, 11, 364. https://doi.org/10.1186/1471-2407-11-364
  20. Lin CH, Liau JY, Lu YS, et al (2009). Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia. Cancer Epidemiol Biomarkers Prev, 18, 1807-14. https://doi.org/10.1158/1055-9965.EPI-09-0096
  21. Lu C, Schneider MT, Gubbins P, et al (2010). Public financing of health in developing countries: a cross-national systematic analysis. Lancet, 375, 1375-87. https://doi.org/10.1016/S0140-6736(10)60233-4
  22. Lu L, Xing ZW, Jun Z, et al (2005). Reform of primary care in China. Lancet, 366, 120. https://doi.org/10.1016/S0140-6736(05)66862-6
  23. Matsuno RK, Anderson WF, Yamamoto S, et al (2007). Earlyand late-onset breast cancer types among women in the United States and Japan. Cancer Epidemiol Biomarkers Prev, 16, 1437-42. https://doi.org/10.1158/1055-9965.EPI-07-0108
  24. Moss S (1999). A trial to study the effect on breast cancer mortality of annual mammographic screening in women starting at age 40. Trial Steering Group. J Med Screen, 6, 144-8. https://doi.org/10.1136/jms.6.3.144
  25. Nelson HD, Tyne K, Naik A, et al (2009). Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med, 151, 727-37, W237-42. https://doi.org/10.7326/0003-4819-151-10-200911170-00009
  26. Nemec CF, Listinsky J, Rim A (2007). How should we screen for breast cancer? Mammography, ultrasonography, MRI. Cleve Clin J Med, 74, 897-904. https://doi.org/10.3949/ccjm.74.12.897
  27. Pediconi F, Catalano C, Roselli A, et al (2009). The challenge of imaging dense breast parenchyma: is magnetic resonance mammography the technique of choice? A comparative study with x-ray mammography and whole-breast ultrasound. Invest Radiol, 44, 412-21. https://doi.org/10.1097/RLI.0b013e3181a53654
  28. Sardanelli F, Giuseppetti GM, Panizza P, et al (2004). Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in Fatty and dense breasts using the whole-breast pathologic examination as a gold standard. AJR Am J Roentgenol, 183, 1149-57. https://doi.org/10.2214/ajr.183.4.1831149
  29. US Preventive Services Task Force (2009). Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med, 151, 716-26, W-236. https://doi.org/10.7326/0003-4819-151-10-200911170-00008
  30. Ya-Jie J, Wei-Jun P, Cai C, et al (2012). Application of Breast Ultrasound in a Mammography-Based Chinese Breast Screening Study. Cell Biochem Biophys, 65, 37-41.
  31. Yang L, Li LD, Chen YD, et al (2006). Time trends, estimates and projects for breast cancer incidence and mortality in China. Zhonghua Zhong Liu Za Zhi, 28, 438-40.
  32. Yang L, Parkin DM, Ferlay J, et al (2005). Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomarkers Prev, 14, 243-50.

Cited by

  1. Analysis of Mammographic Breast Density in a Group of Screening Chinese Women and Breast Cancer Patients vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6411
  2. Breast Cancer Diagnosis by Mammography in Kazakhstan - Staging Results of Breast Cancer with Double Reading vol.16, pp.1, 2015, https://doi.org/10.7314/APJCP.2015.16.1.31
  3. Spatial and Temporal Epidemiological Assessment of Breast Cancer Incidence and Mortality in Kazakhstan, 1999-2013 vol.16, pp.15, 2015, https://doi.org/10.7314/APJCP.2015.16.15.6795
  4. Limitations of mammography in the diagnosis of breast diseases compared with ultrasonography: a single-center retrospective analysis of 274 cases vol.20, pp.1, 2015, https://doi.org/10.1186/s40001-015-0140-6
  5. Clinical significance of high expression of circulating serum lncRNA RP11-445H22.4 in breast cancer patients: a Chinese population-based study vol.36, pp.10, 2015, https://doi.org/10.1007/s13277-015-3469-0
  6. Awareness and current knowledge of breast cancer vol.50, pp.1, 2017, https://doi.org/10.1186/s40659-017-0140-9
  7. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women vol.112, pp.6, 2015, https://doi.org/10.1038/bjc.2015.33
  8. Validation of an information–motivation–behavioral skills model of upper limb functional exercise adherence among Chinese postoperative patients with breast cancer pp.1880-4233, 2019, https://doi.org/10.1007/s12282-018-0911-3
  9. Addition of ultrasound to mammography in the case of dense breast tissue: systematic review and meta-analysis vol.118, pp.12, 2018, https://doi.org/10.1038/s41416-018-0080-3
  10. Role of breast density measurement in screening for breast cancer vol.21, pp.3, 2018, https://doi.org/10.1080/13697137.2018.1424816