Mammography in 53,803 women from the New Hampshire Mammography Network
Mammography in 53,803 women from the New Hampshire Mammography Network
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DOI：
10.1148/radiology.217.3.r00dc33832
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发表时间：
2000-12-01
期刊：
影响因子：
19.7
通讯作者：
Carney, PA
中科院分区：
文献类型：
--
作者：
Poplack, SP;Tosteson, AN;Carney, PA
目的：描述在不同地理区域的人群中乳房X光检查的表现，并评价译员使用乳腺影像报告和数据系统(BI-RADS)的情况。材料和方法：从1996年11月1日至1997年10月31日，来自47,651次筛查和6,152次诊断性检查的乳房X光检查数据与1,572例病理结果相关联。乳房X光检查结果基于BI-RADS评估和口译放射科医生报告的建议。结果：筛查钼靶的敏感性为72.4%(95%CI：66.4%，78.4%)，特异性为97.3%(95%CI：97.25%，97.4%)，阳性预测值为10.6%(95%CI：9.1%，12.2%)。诊断钼靶具有较高的敏感性78.1%(95%CI：71.9%，84.3%)，较低的特异性89.3%(950/0CI：88.5%，90.1%)，较好的阳性预测值17.1%(95%CI：14.5%，19.8%)。筛查乳房X光检查的癌症发现率为3.3‰，活检率为22.4%，而间歇期癌变率为1.2‰。近80%的筛查发现的侵袭性恶性肿瘤是结节阴性的。筛查钼靶的召回率为8.3%。3.5%的筛查和17.5%的诊断性检查使用了超声检查。除了可能的良性评估外，BI-RADS的建议总体上是一致的。结论：在这个以人群为基础的样本中，筛查乳房X光检查的灵敏度低于预期，尽管其他性能指标值得称赞。BI-RADS“可能是良性的”评估经常被滥用。
PURPOSE: To describe measures of mammography performance in a geographically defined population and evaluate the interpreter's use of the Breast Imaging Reporting and Data System (BI-RADS).MATERIALS AND METHODS: Mammographic data from 47,651 screening and 6,152 diagnostic examinations from November 1, 1996, to October 31, 1997, were linked to 1,572 pathologic results. Mammographic outcomes were based on BI-RADS assessments and recommendations reported by the interpreting radiologist. The consistency of BI-RADS recommendations was evaluated.RESULTS: Screening mammography had a sensitivity of 72.4% (95% Cl: 66.4%, 78.4%), specificity of 97.3% (95% Cl: 97.25%, 97.4%), and positive predictive value of 10.6% (95% Cl: 9.1%, 12.2%). Diagnostic mammography had higher sensitivity, 78.1% (95% Cl: 71.9%, 84.3%); lower specificity, 89.3% (950/0 Cl: 88.5%, 90.1%); and better positive predictive value, 17.1% (95% Cl: 14.5%, 19.8%). The cancer detection rate with screening mammography was 3.3 per 1.000 women, with a biopsy yield of 22.4%, whereas the interval cancer rate was 1.2 per 1,000. Nearly 80% of screening-detected invasive malignancies were node negative. The recall rate for screening mammography was 8.3%. Ultrasonography was used in 3.5% of screening and 17.5% of diagnostic examinations. BI-RADS recommendations were generally consistent, except for probably benign assessments.CONCLUSION: The sensitivity of screening mammography in this population-based sample is lower than expected, although other performance indicators are commendable. BI-RADS "probably benign" assessments are commonly misused.