Purpose
Background Breast cancer is a leading cause of death in Western women aged 35-54 years. In the countries of the European Union more than 74,000 deaths are caused annually by breast cancer. In the United States of America over 40,000 women die annually from this disease and approximately 180,000 cases are diagnosed each year. Survival rates are highest when the disease is detected early and still confined to the breast. Mammograhy is the first-line imaging method and can detect clinically occult cancers. Despite technical advances...
Methods and Materials
EIS (TransScan TS2000TM, TransScan Medical, Israel, Siemens-Elema, Sweden, Fig.1) and sonography were performed on 234 BI-RADSTMIII-V lesions in mammograms of 204 women (53.2 +/- 14.1ys). EIS uses a software (2.67) featuring a post-processing function with colored indicator bar representing 5 levels of suspicion. We also used a 5-grade, BI-RADS-like level of suspicion (LOS) scoring method for evaluation of sonography (1-negative, 2-benign finding, 3-probably benign finding, 4-suspicious abnormality, 5-highly suggestive of malignancy). For all modalities, LOS 1, 2 and 3 were considered negative; LOS 4 and...
Results
Histology proved 90 lesions to be malignant, 144 benign. Sensitivitiy, specificity and accuracy rates as well as positive (PPV) and negative predictive values (NPV) were, respectively, 84.8%, 67.6%, 74.4%, 62.9% and 87.3% for EIS, 95.5%, 31.1%, 57.0%, 48.3 and 91,1% for mammography, and 93.2%, 37.1%, 60.1%, 50.7% and 88.5% for sonography. Mean lesion size was 15.7 +/- 10.5 mm. Sensitivity of EIS was higher in lesions of 10 mm size and below (n=87; 94.4%; spec. 72.5%, NPV 94.9%;Fig4a-b), in invasive cancers (65/73; 89.0%; Fig.5a-c) as...
Conclusion
Our results suggest that EIS may be of use in lesion differentiation, particulary in small, in non-palpable lesions, in microcalcifications and in dense breast tissue on the mammogramm (BI-RADSTM-Composition IV). EIS detected all 4 malignancies in BI-RADSTM-0-lesions, and 7 out of 9 non-malignant changes in BI-RADSTM-V-lesions. EIS performed with a lower overall sensitivity compared to mammography and sonography, however EIS presented the highest specificity as well as the highest overall accuracy. In conclusion EIS proved to have adjunctive value in breast lesion differentiation.
References
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Personal Information
Dr. Michael FuchsjgerDepartment of RadiologyUniversity of Vienna Medical SchoolWhringer Grtel 18-20A-1090 ViennaAustriaTel: +43 1 40400 7620Fax: +43 1 40400 4898E-mail:
[email protected]
