Significance and positive predictive values of mammographic findings in the Asia-Pacific region: a single-centre study in Taiwan

Abstract

To report positive predictive values (PPVs) of mammographic findings (MFs) of a screening cohort in Taiwan with a view to providing radiologists around the world with adequate information for assessing MFs before recommending biopsy for Asian women. Between January 2014 and June 2017, 18,449 women received screening mammography at Tri-Service General Hospital (TSGH). Of these women, 1,622 exhibited specific MFs, namely mass (n=518), microcalcification (n=668), focal asymmetry (FA; n=462), and architectural distortion (AD; n=117). The distribution and PPVs of each MF were calculated after stratification based on cancer type, age, and breast density. The age group with the highest proportion of women was 50-59 years (48.1%), and most women presented with dense breasts (68.6%). The most common MF in the recalled women was microcalcification (41.2%) and the least common was AD (7.2%). AD was the most predictive MF for overall breast cancers, invasive carcinomas, and carcinomas in situ. Microcalcification was the second most predictive MF among recalled women for predicting overall breast cancers; however, it was less predictive than mass and FA in women who received a biopsy recommendation or underwent biopsy. AD can indicate the likelihood of breast cancer development in Asian women with abnormal screening results. Benign breast diseases are more likely to occur in women recommended for or receiving breast biopsy owing to microcalcification than to mass or FA.