Breast cancer detection in a screening population: Comparison of digital mammography, computer-aided detection applied to digital mammography and breast ultrasound

Kyu Ran Cho, Bo Kyoung Seo, Ok Hee Woo, Sung Eun Song, Jungsoon Choi, Shin Young Whang, Eun Kyung Park, Ah Young Park, Hyeseon Shin, Hwan Hoon Chung

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: We aimed to compare the detection of breast cancer using full-field digital mammography (FFDM), FFDM with computer-aided detection (FFDM+CAD), ultrasound (US), and FFDM+CAD plus US (FFDM+CAD+US), and to investigate the factors affecting cancer detection. Methods: In this retrospective study conducted from 2008 to 2012, 48,251 women underwent FFDM and US for cancer screening. One hundred seventy-one breast cancers were detected: 115 invasive cancers and 56 carcinomas in situ. Two radiologists evaluated the imaging findings of FFDM, FFDM+CAD, and US, based on the Breast Imaging Reporting and Data System lexicon of the American College of Radiology by consensus. We reviewed the clinical and the pathological data to investigate factors affecting cancer detection. We statistically used generalized estimation equations with a logit link to compare the cancer detectability of different imaging modalities. To compare the various factors affecting detection versus nondetection, we used Wilcoxon rank sum, chi-square, or Fisher exact test. Results: The detectability of breast cancer by US (96.5%) or FFDM+CAD+US (100%) was superior to that of FFDM (87.1%) (p= 0.019 or p< 0.001, respectively) or FFDM+ CAD (88.3%) (p=0.050 or p<0.001, respectively). However, cancer detectability was not significantly different between FFDM versus FFDM+CAD (p=1.000) and US alone versus FFDM+CAD+US (p= 0.126). The tumor size influenced cancer detectability by all imaging modalities (p< 0.050). In FFDM and FFDM+CAD, the nondetecting group consisted of younger patients and patients with a denser breast composition (p< 0.050). In breast US, carcinoma in situ was more frequent in the nondetecting group (p= 0.014). Conclusion: For breast cancer screening, breast US alone is satisfactory for all age groups, although FFDM+ CAD+US is the perfect screening method. Patient age, breast composition, and pathological tumor size and type may influence cancer detection during screening.

Original languageEnglish
Pages (from-to)316-323
Number of pages8
JournalJournal of Breast Cancer
Volume19
Issue number3
DOIs
Publication statusPublished - 2016 Sep 1

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Mammography
Breast
Breast Neoplasms
Population
Neoplasms
Carcinoma in Situ
Early Detection of Cancer
Radiology
Information Systems

Keywords

  • Breast neoplasms
  • Computer-assisted diagnosis
  • Early detection of cancer
  • Mammary ultrasonography
  • Mammography

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Breast cancer detection in a screening population : Comparison of digital mammography, computer-aided detection applied to digital mammography and breast ultrasound. / Cho, Kyu Ran; Seo, Bo Kyoung; Woo, Ok Hee; Song, Sung Eun; Choi, Jungsoon; Whang, Shin Young; Park, Eun Kyung; Park, Ah Young; Shin, Hyeseon; Chung, Hwan Hoon.

In: Journal of Breast Cancer, Vol. 19, No. 3, 01.09.2016, p. 316-323.

Research output: Contribution to journalArticle

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abstract = "Purpose: We aimed to compare the detection of breast cancer using full-field digital mammography (FFDM), FFDM with computer-aided detection (FFDM+CAD), ultrasound (US), and FFDM+CAD plus US (FFDM+CAD+US), and to investigate the factors affecting cancer detection. Methods: In this retrospective study conducted from 2008 to 2012, 48,251 women underwent FFDM and US for cancer screening. One hundred seventy-one breast cancers were detected: 115 invasive cancers and 56 carcinomas in situ. Two radiologists evaluated the imaging findings of FFDM, FFDM+CAD, and US, based on the Breast Imaging Reporting and Data System lexicon of the American College of Radiology by consensus. We reviewed the clinical and the pathological data to investigate factors affecting cancer detection. We statistically used generalized estimation equations with a logit link to compare the cancer detectability of different imaging modalities. To compare the various factors affecting detection versus nondetection, we used Wilcoxon rank sum, chi-square, or Fisher exact test. Results: The detectability of breast cancer by US (96.5{\%}) or FFDM+CAD+US (100{\%}) was superior to that of FFDM (87.1{\%}) (p= 0.019 or p< 0.001, respectively) or FFDM+ CAD (88.3{\%}) (p=0.050 or p<0.001, respectively). However, cancer detectability was not significantly different between FFDM versus FFDM+CAD (p=1.000) and US alone versus FFDM+CAD+US (p= 0.126). The tumor size influenced cancer detectability by all imaging modalities (p< 0.050). In FFDM and FFDM+CAD, the nondetecting group consisted of younger patients and patients with a denser breast composition (p< 0.050). In breast US, carcinoma in situ was more frequent in the nondetecting group (p= 0.014). Conclusion: For breast cancer screening, breast US alone is satisfactory for all age groups, although FFDM+ CAD+US is the perfect screening method. Patient age, breast composition, and pathological tumor size and type may influence cancer detection during screening.",
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AU - Cho, Kyu Ran

AU - Seo, Bo Kyoung

AU - Woo, Ok Hee

AU - Song, Sung Eun

AU - Choi, Jungsoon

AU - Whang, Shin Young

AU - Park, Eun Kyung

AU - Park, Ah Young

AU - Shin, Hyeseon

AU - Chung, Hwan Hoon

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KW - Computer-assisted diagnosis

KW - Early detection of cancer

KW - Mammary ultrasonography

KW - Mammography

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