Sydney Breast Imaging Accuracy Study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms.
Sydney Breast Imaging Accuracy Study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms.
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DOI：
10.2214/ajr.180.4.1800935
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发表时间：
2003-04-01
影响因子：
5
通讯作者：
Noakes, J
中科院分区：
文献类型：
--
作者：
Houssami, N;Irwig, L;Noakes, J
目标。我们检查了有症状的女性乳腺X光摄影和超声检查的年龄特异性和敏感性，以确定超声检查可能是更准确的影像检查的年龄，这可能会指导根据女性的年龄选择初始乳房影像检查。480名受试者是从1994至1996年间连续到有症状的乳腺诊所就诊的所有女性中抽取的，年龄从25岁到55岁不等。我们纳入了所有240名患有乳腺癌的女性(从而避免了选择偏见)和240名年龄匹配的未患癌症的女性。乳房X光检查和超声检查由两名放射科医生盲目地在不知道年龄的情况下进行前瞻性的独立解释，另一名放射科医生仲裁分歧。结果：每种检查的灵敏度和特异度与年龄不呈线性相关；然而，在50岁以上的女性中，钼靶摄影的灵敏度和特异度显著增加。超声敏感性为81.7%，钼靶敏感性为75.8%，两者差异无统计学意义(chi(1)(2)=2.06，p=0.15)。然而，在45岁或以下的女性中，超声检查的敏感性比乳房X光检查高13.2%(95%可信区间，2.1-24.3%)。两种检查的特异度约为88.0%。结论：这些数据表明，对于45岁或以下有乳房症状的女性，超声检查是更准确的影像检查，可能是一种合适的初步影像检查。
OBJECTIVE. We examined the age-specific sensitivity and specificity of mammography and sonography in symptomatic women to determine the age below which sonography may be the more accurate imaging test, which may guide the choice of initial breast imaging examination based on the woman's age.MATERIALS AND METHODS. Four hundred eighty subjects were sampled from all women consecutively attending a symptomatic breast clinic between 1994 and 1996 and ranging in age from 25 to 55 years. We included all 240 women shown to have breast cancer (thus avoiding selection bias) and 240 age-matched women shown not to have cancer. Mammograms and sonograms were prospectively interpreted independently and without knowledge of age by two radiologists in a blinded manner, with a third radiologist arbitrating disagreements. Sensitivity and specificity of each imaging test in relation to age were examined using logistic regression modeling, and accuracy was compared using the chi-square test for paired proportions.RESULTS. Sensitivity and specificity of each test were not linearly associated with age; however, the sensitivity of mammography increased substantially in women older than 50 years. Sonographic sensitivity of 81.7% was not significantly greater than mammographic sensitivity of 75.8% (chi(1)(2) = 2.06, p = 0.15). However, in women 45 years old or younger, the sensitivity of sonography was 13.2% (95% confidence interval, 2.1-24.3%) greater than that of mammography. The specificity of both tests was approximately 88.0%.CONCLUSION. These data show that sonography is the more accurate imaging test in women 45 years old or younger who present with breast symptoms and may be an appropriate initial imaging examination.