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Evaluation of Screening US-detected Breast Masses by Combined Use of Elastography and Color Doppler US with B-Mode US in Women with Dense Breasts: A Multicenter Prospective Study

 Su Hyun Lee  ;  Jin Chung  ;  Hye Young Choi  ;  Seon Hyeong Choi  ;  Eun Bi Ryu  ;  Kyung Hee Ko  ;  Hye Ryoung Koo  ;  Jeong Seon Park  ;  Ann Yi  ;  Ji Hyun Youk  ;  Eun Ju Son  ;  A Jung Chu  ;  Jung Min Chang  ;  Nariya Cho  ;  Myoung-jin Jang  ;  Shin Ho Kook  ;  Eun Suk Cha  ;  Woo Kyung Moon 
 RADIOLOGY, Vol.285(2) : 660-669, 2017 
Journal Title
Issue Date
Adult ; Breast/diagnostic imaging* ; Breast/physiology ; Breast Neoplasms/diagnostic imaging* ; Female ; Humans ; Middle Aged ; Prospective Studies ; Ultrasonography, Doppler, Color/methods* ; Ultrasonography, Mammary/methods*
Purpose To investigate the value of the combined use of elastography and color Doppler ultrasonography (US) with B-mode US for evaluation of screening US-detected breast masses in women with dense breasts. Materials and Methods This prospective, multicenter study included asymptomatic women with dense breasts who were referred for screening US between November 2013 and December 2014. Eligible women had a newly detected breast mass at conventional B-mode US screening, for which elastography and color Doppler US were performed. The following outcome measures were compared between B-mode US and the combination of B-mode US, elastography, and color Doppler US: area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and the number of false-positive findings at screening US. Results Among 1021 breast masses (mean size, 1.0 cm; range, 0.3-3.0 cm) in 1021 women (median age, 45 years), 68 were malignant (56 invasive). Addition of elastography and color Doppler US to B-mode US increased the AUC from 0.87 (95% confidence interval [CI]: 0.82, 0.91) to 0.96 (95% CI: 0.95, 0.98; P < .001); specificity from 27.0% (95% CI: 24.2%, 29.9%) to 76.4% (95% CI: 73.6%, 79.1%; P < .001) without loss in sensitivity (95% CI: -1.5%, 1.5%; P > .999); and PPV from 8.9% (95% CI: 7.0%, 11.2%) to 23.2% (95% CI: 18.5%, 28.5%; P < .001), while avoiding 67.7% (471 of 696) of unnecessary biopsies for nonmalignant lesions. Conclusion Addition of elastography and color Doppler US to B-mode US can increase the PPV of screening US in women with dense breasts while reducing the number of false-positive findings without missing cancers. © RSNA, 2017 Online supplemental material is available for this article.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
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