Diagnostic value of ultrasound diffusion breast imaging system for breast cancer of T1 stage

Abstract

Objective To investigate the application of the ultrasound diffusion breast imaging(UDBI) system in the diagnosis of T1 stage breast cancer. Methods Totally 2 245 patients with ultrasound grade 3 and above (the patients in grade 6 were excluded) in the Chengdu Women’s and Children’s Central Hospital from April 2016 to April 2018 were included in this study. The patients underwent both ultrasonography and UDBI. Among them, 1 157 patients underwent biopsy, with complete pathological data, so they were retrospectively analyzed. According to the maximum diameter of the tumor, 1 157 cases were divided into 3 groups: 452 cases in S1 group (≤1.0 cm), 489 cases in S2 group (1.1-2.0 cm), and 216 cases in S3 group (>2.0 cm). The receiver operating characteristic (ROC) curve was used to analyze the diagnostic performance of the two methods. The area under the ROC curve and 95%CI were calculated accordingly. The area under the ROC curve was compared by Z test using the Medcalc V19.0.4 software. The sensitivity and specificity of the two methods were compared by χ2 test or Fisher exact test. The paired χ2 test (McNemar test) was used to compare the two methods with pathological results. Results Among the 1 157 cases, there were 144 cases of malignant tumor (12.4%), confirmed as invasive ductal carcinoma, 1 013 cases of benign disease (87.6%), including 852 cases of fibroadenoma, 49 intraductal papilloma and 112 adenosis. The sensitivity, specificity and diagnostic accuracy in the diagnosis of breast cancer were 90.2% (130/144), 67.7% (686/1 013) and 70.5 (816/1 157) by ultrasound, 94.4% (136/144), 81.8% (829/1 013) and 83.4% (965/1 157) by UDBI, respectively. The diagnostic accuracy and specificity of UDBI were significantly higher than those of ultrasound (χ2=55.148, P 2.0 cm, there was no significant difference in the diagnostic performance between UDBI and ultrasound (Z=1.911, P=0.056). Subgroup analysis showed that for the tumor with the diameter of 0-1.0 cm, the specificity of UDBI was significantly higher than that of ultrasound [85.7% (359/419) vs 72.3% (303/419), χ2=22.555, P 2.0 cm, the specificity of UDBI was significantly higher than that of ultrasound [73.1% (117/160) vs 58.1% (93/160), χ2=7.979, P=0.005]. There was no significant difference in the sensitivity between UDBI and ultrasound in each subgroup (P=0.427; χ2=0.374, P=0.541; P=1.000). Conclusion The UDBI is superior to ultrasound in the diagnosis of breast cancer of T1 stage, which can be used as an effective method for early breast cancer diagnosis. Key words: Ultrasonography; Breast neoplasms; Early diagnosis; Ultrasound diffusion breast imaging system