Abstract
In Asian countries, ultrasound has been proposed as a possible alternative for mammography in breast cancer screening because of its superiority in dense breasts, accessibility and low costs. This research aimed to meta-analyze the evidence for the diagnostic performance of ultrasound compared to mammography for breast cancer screening in Asian women. PubMed, Web of Science, and China National Knowledge Infrastructure databases were searched for studies that concurrently compared mammography and ultrasound in 2000–2019. Data extraction and risk of bias were performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) statement. The primary outcome was the sensitivity and specificity. Bivariate random models were used to generate pooled estimates of diagnostic parameters and 95% confidence intervals (95% CI). In total, 4424 studies were identified of which six studies met the inclusion criteria with a sample size of 124,425 women. The pooled mean prevalence of the included studies was 3.7‰ (range: 1.2–5.7‰). The pooled sensitivity of mammography was significantly higher than that of ultrasound (0.81 [95% CI 0.71–0.88] versus 0.65 [95% CI 0.58–0.72], p = 0.03), but no significant differences were found in specificity (0.98 [95% CI: 0.94–1.00] versus 0.99 [95% CI: 0.97–1.00], p = 0.65). In conclusion, based on the currently available data on sensitivity alone, there is no indication that ultrasound can replace mammography in breast cancer screening in Asian women.
Highlights
Breast cancer is nowadays the main cause of cancer-related death in Asian women, with a dramatic increase in age-standardized incidence over recent years [1,2]
Controversies about the efficiency of breast cancer screening still exist, several successful organized screening programs introduced in European and North American countries have shown that breast cancer mortality can be reduced by
PubMed, Web of Science, and China National Knowledge Infrastructure databases were searched with the following keywords: “breast neoplasms”, “breast cancer”, “mass screening”, “ultrasound”, “radiography”, “mammography”, and “Asia”
Summary
Breast cancer is nowadays the main cause of cancer-related death in Asian women, with a dramatic increase in age-standardized incidence over recent years [1,2]. Data from China, South Korea, and Singapore showed that, during the period from 1988 to 2009, the estimated annual increase of the age-standardized incidence ranged from 2.0% to 6.4% [3]. There is no universally effective method to lower the incidence of breast cancer [4,5]. Regular screening could reduce disease burden as more cancers could be detected at earlier stages, allowing for better treatment and survival [6]. Controversies about the efficiency of breast cancer screening still exist, several successful organized screening programs introduced in European and North American countries have shown that breast cancer mortality can be reduced by
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