유방암 진단에 있어 유방조영술 단독검사와 유방초음파촬영술 병행검사의 임상적 가치 비교

Abstract

Background : Because the sensitivity of mammography (MAM) is lower in young women than in old and in women with dense breast than those without, many physicians utilize breast ultrasonography (US) with MAM. But the addictive value of US is unclear. This study compared the diagnostic value between MAM and MAM+US.

Methods : Between September, 2002, and February, 2003, there were 89 cases of breast disease confirmed by surgery, that had both MAM and US results. The results of MAM and US were classifed by Breast Imaging Reporting and Data System (BI-RADS) and were categorized as positive or negative. Among the positive results, BI-RADS Category 0 and Category 3 with recommendation of other test were regarded as an intermediate result.

Results : Among all 89 cases, 38 cases were malignancies. The receiver operating characteristic curves showed non-significant increase in diagnostic value by adding US to MAM. The sensitivity of MAM was non-significantly higher in above-50-years women than in below- 49-years women and in women with dense breast than in women with non-dense breast. Among positive results of MAM, 21 cases were ’intermediate results’. US correctly regraded 8 benign lesions from 19 cases of false-positive MAM and 1 extra malignancy with palpable lump from 4 false-negative MAM.

Conclusion : MAM is a valuable test in diagnosing breast cancer. US is a valuable complementary test to MAM in evaluating palpable lump with negative MAM and intermediate result of MAM.