机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China[2]Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin, China[3]Department of Ultrasound, the Second Affiliated Hospital of Chongqing Medical University & Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China[4]Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China中国医科大学附属盛京医院中国医科大学盛京医院[5]Department of Medical Ultrasound, Fudan University Shanghai Cancer Center & Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China[6]Department of Ultrasonography, Henan Provincial People s Hospital, Zhengzhou, China[7]Department of Ultrasound, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China山西白求恩医院[8]Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China华中科技大学同济医学院附属同济医院[9]Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China吉林大学中日联谊医院[10]Department of Ultrasound, the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China中山大学附属第二医院[11]Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning, China[12]Department of Medical Ultrasound, the Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, China[13]Department of Ultrasound, Union Hospital of Fujian Medical University, Fujian Institute of Ultrasound Medicine, Fuzhou, China[14]Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China[15]Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan, China[16]Department of Ultrasound, Qilu Hospital, Shandong University, Jinan, China[17]Department of Ultrasound, the Third Xiangya Hospital of Central South University, Changsha, China[18]Department of Ultrasound, the Second Affiliated Hospital of Nanchang University, Nanchang, China[19]Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[20]Department of Ultrasonography, the Affiliated Hospital of Guizhou Medical University, Guiyang, China[21]Department of Ultrasound, Shenzhen People’s Hospital, the Second Clinical Medical College of Jinan University, Shenzhen, China深圳市康宁医院深圳市人民医院深圳医学信息中心[22]Department of Ultrasound, the First Hospital of Shanxi Medical University, Taiyuan, China[23]Department of Ultrasound, the Second Hospital of Dalian Medical University, Dalian, China
We assessed the performance of conventional ultrasound (US) combined with strain elastography (SE) in the Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions on mammography. A total of 751 women with 751 breast lesions classified as mammographic BI-RADS category 4 were included. Conventional US combined with SE helped increase the PPV and had the potential to avoid unnecessary biopsies of BI-RADS category 4 lesions detected on mammography. Background: To assess the performance of conventional ultrasound (US) combined with strain elastography (SE) in the Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions on mammography. Materials and Methods: Women with breast lesions identified as having mammography BI-RADS 4 lesions and underwent US examination were included in China. US features and US BI-RADS assessment were recorded in real-time and prospectively reported. The pathological result was referred to as the gold standard. The performance of US in the mammographic BI-RADS category 4 lesions was evaluated. Diagnostic performances of US BI-RADS, SE and combined both were compared. Results: A total of 751 women with 751 breast lesions classified as mammographic BI-RADS category 4 were included. For mammographic findings, 530 (70.6%) were true positive and 221 (29.4%) were false positive. Conventional US achieved higher positive predictive value (PPV) than mammography (78.5% vs. 70.6%, P=.001). The specificity increased from 34.4% to 47.1% (P < . .001) without any loss in sensitivity and the PPV increased to 81.9% (P = .122) when conventional US was used in combination with SE. For conventional US combined with SE, it led to a correct diagnosis of no breast cancer in 104 of the 221 false-positive findings (47.1%) and achieved higher PPV than mammography regardless of patient age and lesion size. Conclusion: Conventional US combined with SE is a helpful tool for the noninvasive examination of breast lesions classified as BI-RADS category 4 on mammography. It helped increase the PPV and had the potential to avoid unnecessary biopsies of BI-RADS category 4 lesions detected on mammography. (C) 2021 Elsevier Inc. All rights reserved.
基金：
This work is supported by the Beijing Natural Science Foundation ( 7202156 ), the Foundation of International Health Exchange and Cooperation Center NHC PRC ( ihecc2018C0032- 2 ), Peking Union Medical College Reform in Education Project ( 10023201900113 ).
第一作者机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
通讯作者：
通讯机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China[*1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
推荐引用方式(GB/T 7714)：
Gu Yang,Tian Jiawei,Ran Haitao,et al.Can Ultrasound Elastography Help Better Manage Mammographic BI-RADS Category 4 Breast Lesions?[J].CLINICAL BREAST CANCER.2022,22(4):E407-E416.doi:10.1016/j.clbc.2021.10.009.
APA：
Gu, Yang,Tian, Jiawei,Ran, Haitao,Ren, Weidong,Chang, Cai...&Jiang, Yuxin.(2022).Can Ultrasound Elastography Help Better Manage Mammographic BI-RADS Category 4 Breast Lesions?.CLINICAL BREAST CANCER,22,(4)
MLA：
Gu, Yang,et al."Can Ultrasound Elastography Help Better Manage Mammographic BI-RADS Category 4 Breast Lesions?".CLINICAL BREAST CANCER 22..4(2022):E407-E416
