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Can Ultrasound Elastography Help Better Manage Mammographic BI-RADS Category 4 Breast Lesions?

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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 [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 [8]Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China [9]Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China [10]Department of Ultrasound, the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China [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 [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

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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.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.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.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.Copyright © 2021. Published by Elsevier Inc.

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出版当年[2020]版：

大类 | 3 区医学

小类 | 4 区肿瘤学

最新[2025]版：

大类 | 3 区医学

小类 | 4 区肿瘤学

第一作者：

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

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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

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