21 april 2020: Omdat ik een vraag kreeg over de effectiviteit van Ultra Sound bij kanker in het algemeen kwam ik bij mijn zoektocht enkele studies tegen over het gebruik van Ultra Sound als extra diagnose methode bij borstkanker zoals onderstaand artikel al in 2008 geplaatst.

Bv. deze studie: Breast cancer detection using sonography in women with mammographically dense breasts.

Met als conclusie:

Borst-echografie (Ultra Sound) als aanvullend beeldvormingsinstrument ontdekte 27% meer kwaadaardige borst-laesies die anders door een standaard mammografie werden gemist bij deze symptomatische (= vrouwen met klachten die zouden kunnen duiden op borstkanker) vrouwen met mammografisch dichte borsten. We raden Ultra Sound aan bij routinematige evaluatie van symptomatische vrouwen met mammografisch dichte borsten. Abstract staat onderaan artikel.

Ook deze reviewstudie uit 2019: Ultrasound for Breast Cancer Detection Globally: A Systematic Review and Meta-Analysis geeft uitstekende informatie over de waarde van een extra Ultra Sound diagnose naast een standaard borstkankerdiagnose bij vrouwen met grote borstdichtheid en bevestigft de resultaten uit eerder genoemde studie. Abstract plus referentielijst hiervan staat ook onderaan artikel.

18 november 2008: Bron: 1: Breast Cancer. 2008;15(2):165-8. Epub 2008 Jan 26. Links

Wanneer een mammografie wordt uitgebreid met een diagnose met ultrasound dan worden nog eens 15% van verdacht weefsel op correcte wijze gediagnosteerd. Dit blijkt uit een gerandomiseerde studie onder ruim 9000 Japanse vrouwen. Zie hieronder het abstract van de studie.

Screening ultrasonography revealed 15% of mammographically occult breast cancers.

Uchida K, Yamashita A, Kawase K, Kamiya K.

Department of Breast and Endocrine Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan, kenucd@jikei.ac.jp.

BACKGROUND: Mammography and physical examination (PE) are the recommended modalities for breast-cancer screening for women 40 years and older in Japan. Mammography, however, cannot detect lesions in dense breast tissue, which is common in Japanese women. Breast screening by ultrasound (US) is popular in Japan. We studied which modality or combinations of modalities optimize breast cancer detection for Japanese women.

METHODS: From April 1993 through March 2005 we found 97 breast cancers in 9,082 women by screening examinations with mammography, US, and PE. We compared the detection rates of these three modalities for breast cancer.

RESULTS: The detection rates of mammography, US, and PE for breast cancer were 83.5 (81 of 97 cancers), 75.3 (73 of 97 cancers), and 60.8% (59 of 97 cancers), respectively. The detection rates of the combinations of mammography and US, mammography and PE, and US and PE were 99.0 (96 of 97 cancers), 88.7 (86 of 97 cancers), and 81.4% (79 of 97 cancers), respectively. Ultrasonography detected 15% of the mammographically occult breast cancers.

CONCLUSION: Screening with the combination of mammography and US significantly increases the detection rate of breast cancer. These results suggest that screening with mammography and US would optimize cancer detection in Japanese women.

PMID: 18224382 [PubMed - in process]

Breast ultrasound scan as a supplementary imaging tool detected 27% more malignant mass lesions otherwise missed by mammography among these symptomatic women with mammographically dense breasts. We recommend that ultra sound scanning in routine evaluation of symptomatic women with mammographically dense breasts.

2014 Dec 30;14:41. doi: 10.1186/s12880-014-0041-0.

Breast cancer detection using sonography in women with mammographically dense breasts.

Okello J1, Kisembo H2, Bugeza S3, Galukande M4.

Author information

Abstract

BACKGROUND:

Mammography, the gold standard for breast cancer screening misses some cancers, especially in women with dense breasts. Breast ultrasonography as a supplementary imaging tool for further evaluation of symptomatic women with mammographically dense breasts may improve the detection of mass lesions otherwise missed at mammography. The purpose of this study was to determine the incremental breast cancer detection rate using US scanning in symptomatic women with mammographically dense breasts in a resource poor environment.

METHODS:

A cross sectional descriptive study. Women referred for mammography underwent bilateral breast ultrasound, and mammography for symptom evaluation. The lesions seen by both modalities were described using sonographic BI-RADS lexicon and categorized. Ultrasound guided core biopsies were performed. IRB approval was obtained and all participants provided informed written consent.

RESULTS:

In total 148 women with mammographically dense breasts were recruited over six months. The prevalence of breast cancer in symptomatic women with mammographically dense breasts was 22/148 (15%). Mammography detected 16/22 (73%) of these cases and missed 6/22 (27%). The six breast cancer cases missed were correctly diagnosed on breast ultrasonography. Sonographic features typical of breast malignancy were irregular shape, non-parallel orientation, non circumscribed margin, echogenic halo, and increased lesion vascularity (p values < 0.005). Typical sonofeatures of benign mass lesions were: oval shape, parallel orientation and circumscribed margin (p values <0.005).

CONCLUSION:

Breast ultrasound scan as a supplementary imaging tool detected 27% more malignant mass lesions otherwise missed by mammography among these symptomatic women with mammographically dense breasts. We recommend that ultra sound scanning in routine evaluation of symptomatic women with mammographically dense breasts.

PMID:: 25547239
PMCID:: PMC4311471
DOI:: 10.1186/s12880-014-0041-0

Portable ultrasound could serve as a global primary detection modality and triage method for breast lesions, particularly in low-resource areas where mammography is currently unavailable or infeasible.

2019 Aug;5:1-17. doi: 10.1200/JGO.19.00127.

Ultrasound for Breast Cancer Detection Globally: A Systematic Review and Meta-Analysis.

Sood R1,2, Rositch AF3, Shakoor D1, Ambinder E1, Pool KL2,4, Pollack E2,5, Mollura DJ2, Mullen LA1, Harvey SC1,2.

Author information

Abstract

PURPOSE:

Mammography is not always available or feasible. The purpose of this systematic review and meta-analysis is to assess the diagnostic performance of ultrasound as a primary tool for early detection of breast cancer.

MATERIALS AND METHODS:

For this systematic review and meta-analysis, we comprehensively searched PubMed and SCOPUS to identify articles from January 2000 to December 2018 that included data on the performance of ultrasound for detection of breast cancer. Studies evaluating portable, handheld ultrasound as an independent detection modality for breast cancer were included. Quality assessment and bias analysis were performed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity analyses and meta-regression were used to explore heterogeneity. The study protocol has been registered with the international prospective register of systematic reviews (PROSPERO identifier: CRD42019127752).

RESULTS:

Of the 526 identified studies, 26 were eligible for inclusion. Ultrasound had an overall pooled sensitivity and specificity of 80.1% (95% CI, 72.2% to 86.3%) and 88.4% (95% CI, 79.8% to 93.6%), respectively. When only low- and middle-income country data were considered, ultrasound maintained a diagnostic sensitivity of 89.2% and specificity of 99.1%. Meta-analysis of the included studies revealed heterogeneity. The high sensitivity of ultrasound for the detection of breast cancer was not statistically significantly different in subgroup analyses on the basis of mean age, risk, symptoms, study design, bias level, and study setting.

CONCLUSION:

Given the increasing burden of breast cancer and infeasibility of mammography in certain settings, we believe these results support the potential use of ultrasound as an effective primary detection tool for breast cancer, which may be beneficial in low-resource settings where mammography is unavailable.

PMID:: 31454282
PMCID:: PMC6733207
DOI:: 10.1200/JGO.19.00127; REFERENCES

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424. [PubMed] [Google Scholar]

2. World Health Organization: Medical equipment: Mammography units per million females aged between 50-69 years old. World Health Organization, 2014. https://www.who.int/diagnostic_imaging/collaboration/mammunitpermill_14.jpg?ua=1.

3. Sprague BL, Arao RF, Miglioretti DL, et al. National performance benchmarks for modern diagnostic digital mammography: Update from the Breast Cancer Surveillance Consortium. Radiology. 2017;283:59–69. [PMC free article] [PubMed] [Google Scholar]

4. da Costa Vieira RA, Biller G, Uemura G, et al. Breast cancer screening in developing countries. Clinics (São Paulo) 2017;72:244–253. [PMC free article] [PubMed] [Google Scholar]

5. Shetty MK. Screening and diagnosis of breast cancer in low-resource countries: What is state of the art? Semin Ultrasound CT MR. 2011;32:300–305. [PubMed] [Google Scholar]

6. Yip CH, Smith RA, Anderson BO, et al. Guideline implementation for breast healthcare in low- and middle-income countries: Early detection resource allocation. Cancer. 2008;113(8) suppl:2244–2256. [PubMed] [Google Scholar]

7. Athanasiou A, Tardivon A, Ollivier L, et al. How to optimize breast ultrasound. Eur J Radiol. 2009;69:6–13. [PubMed] [Google Scholar]

8. Bae MS, Moon WK, Chang JM, et al. Breast cancer detected with screening US: Reasons for nondetection at mammography. Radiology. 2014;270:369–377. [PubMed] [Google Scholar]

9. Nothacker M, Duda V, Hahn M, et al. Early detection of breast cancer: Benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review. BMC Cancer. 2009;9:335. [PMC free article] [PubMed] [Google Scholar]

10. Torre LA, Siegel RL, Ward EM, et al. Global cancer incidence and mortality rates and trends--An update. Cancer Epidemiol Biomarkers Prev. 2016;25:16–27. [PubMed] [Google Scholar]

11. Anderson BO, Yip CH, Smith RA, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: Overview of the Breast Health Global Initiative Global Summit 2007. Cancer. 2008;113(8) suppl:2221–2243. [PubMed] [Google Scholar]

12. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108. [PubMed] [Google Scholar]

13. Anderson BO. Breast cancer--Thinking globally. Science. 2014;343:1403. [PubMed] [Google Scholar]

14. Yip CH, Buccimazza I, Hartman M, et al. Improving outcomes in breast cancer for low and middle income countries. World J Surg. 2015;39:686–692. [PubMed] [Google Scholar]

15. Ginsburg O, Rositch AF, Conteh L, et al: Breast cancer disparities among women in low- and middle-income countries. Current Breast Cancer Reports 10:179-186, 2018.

16. Sloan FA, Gelband H (eds): The cancer burden in low- and middle-income countries and how it is measured, in Cancer Control Opportunities in Low- and Middle-Income Countries. Washington, DC, National Academies Press, 2007. [Google Scholar]

17. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529–536. [PubMed] [Google Scholar]

18. Thompson SG, Higgins JP. How should meta-regression analyses be undertaken and interpreted? Stat Med. 2002;21:1559–1573. [PubMed] [Google Scholar]

19. Devillé WL, Buntinx F, Bouter LM, et al. Conducting systematic reviews of diagnostic studies: Didactic guidelines. BMC Med Res Methodol. 2002;2:9. [PMC free article] [PubMed] [Google Scholar]

20. Rutter CM, Gatsonis CA. A hierarchical regression approach to meta-analysis of diagnostic test accuracy evaluations. Stat Med. 2001;20:2865–2884. [PubMed] [Google Scholar]

21. Borenstein M, Hedges LV, Higgins JP, et al. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods. 2010;1:97–111. [PubMed] [Google Scholar]

22. Deeks JJ, Macaskill P, Irwig L. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol. 2005;58:882–893. [PubMed] [Google Scholar]

23. Mavridis D, Salanti G. How to assess publication bias: Funnel plot, trim-and-fill method and selection models. Evid Based Ment Health. 2014;17:30. [PubMed] [Google Scholar]

24. Duval S, Tweedie R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56:455–463. [PubMed] [Google Scholar]

25. Weigert JM. The Connecticut Experiment; the third installment: 4 years of screening women with dense breasts with bilateral ultrasound. Breast J. 2017;23:34–39. [PubMed] [Google Scholar]

26. Tan KP, Mohamad Azlan Z, Rumaisa MP, et al. The comparative accuracy of ultrasound and mammography in the detection of breast cancer. Med J Malaysia. 2014;69:79–85. [PubMed] [Google Scholar]

27. Devolli-Disha E, Manxhuka-Kërliu S, Ymeri H, et al. Comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density. Bosn J Basic Med Sci. 2009;9:131–136. [PMC free article] [PubMed] [Google Scholar]

28. Irurhe NK, Adekola OO, Awosanya GO, et al. The accuracy of ultrasonography in the diagnosis of breast pathology in symptomatic women. Nig Q J Hosp Med. 2012;22:236–239. [PubMed] [Google Scholar]

29. Matovu A, Scheel JR, Shadrak PA, et al. Pilot study of a resource-appropriate strategy for downstaging breast cancer in rural Uganda. The Journal of Global Radiology. 2016;2:1–6. [Google Scholar]

30. Omidiji OA, Campbell PC, Irurhe NK, et al. Breast cancer screening in a resource poor country: Ultrasound versus mammography. Ghana Med J. 2017;51:6–12. [PMC free article] [PubMed] [Google Scholar]

31. Singh K, Azad A, Gupta D. The accuracy of ultrasound in diagnosis of palpable breast lumps. JK Science. 2008;10:186–188. [Google Scholar]

32. World Bank: World Bank List of Economies. 2018. [Google Scholar]

33. Kuhl CK, Schrading S, Leutner CC, et al. Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol. 2005;23:8469–8476. [PubMed] [Google Scholar]

34. Shen S, Zhou Y, Xu Y, et al. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women. Br J Cancer. 2015;112:998–1004. [PMC free article] [PubMed] [Google Scholar]

35. Hou MF, Chuang HY, Ou-Yang F, et al. Comparison of breast mammography, sonography and physical examination for screening women at high risk of breast cancer in Taiwan. Ultrasound Med Biol. 2002;28:415–420. [PubMed] [Google Scholar]

36. Lehman CD, Isaacs C, Schnall MD, et al. Cancer yield of mammography, MR, and US in high-risk women: Prospective multi-institution breast cancer screening study. Radiology. 2007;244:381–388. [PubMed] [Google Scholar]

37. Sim LS, Hendriks JH, Fook-Chong SM. Breast ultrasound in women with familial risk of breast cancer. Ann Acad Med Singapore. 2004;33:600–606. [PubMed] [Google Scholar]

38. Warner E, Plewes DB, Shumak RS, et al. Comparison of breast magnetic resonance imaging, mammography, and ultrasound for surveillance of women at high risk for hereditary breast cancer. J Clin Oncol. 2001;19:3524–3531. [PubMed] [Google Scholar]

39. Bahl M, Baker JA, Greenup RA, et al. Diagnostic value of ultrasound in female patients with nipple discharge. AJR Am J Roentgenol. 2015;205:203–208. [PubMed] [Google Scholar]

40. Houssami N, Irwig L, Simpson JM, et al. Sydney Breast Imaging Accuracy study: Comparative sensitivity and specificity of mammography and sonography in young women with symptoms. AJR Am J Roentgenol. 2003;180:935–940. [PubMed] [Google Scholar]

41. Shao H, Li B, Zhang X, et al. Comparison of the diagnostic efficiency for breast cancer in Chinese women using mammography, ultrasound, MRI, and different combinations of these imaging modalities. J XRay Sci Technol. 2013;21:283–292. [PubMed] [Google Scholar]

42. Lehman CD, Lee CI, Loving VA, et al. Accuracy and value of breast ultrasound for primary imaging evaluation of symptomatic women 30-39 years of age. AJR Am J Roentgenol. 2012;199:1169–1177. [PubMed] [Google Scholar]

43. doi: 10.1093/jnci/djv367. Berg WA, Bandos AI, Mendelson EB, et al: Ultrasound as the primary screening test for breast cancer: analysis from ACRIN 6666. J Natl Cancer Inst . [PMC free article] [PubMed] [CrossRef] [Google Scholar]

44. Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: An analysis of 27,825 patient evaluations. Radiology. 2002;225:165–175. [PubMed] [Google Scholar]

45. Leong LC, Gogna A, Pant R, et al. Supplementary breast ultrasound screening in Asian women with negative but dense mammograms-a pilot study. Ann Acad Med Singapore. 2012;41:432–439. [PubMed] [Google Scholar]

46. Uchida K, Yamashita A, Kawase K, et al. Screening ultrasonography revealed 15% of mammographically occult breast cancers. Breast Cancer. 2008;15:165–168. [PubMed] [Google Scholar]

47. Youk JH, Kim EK, Kim MJ, et al. Performance of hand-held whole-breast ultrasound based on BI-RADS in women with mammographically negative dense breast. Eur Radiol. 2011;21:667–675. [PubMed] [Google Scholar]

48. Girardi V, Tonegutti M, Ciatto S, et al. Breast ultrasound in 22,131 asymptomatic women with negative mammography. Breast. 2013;22:806–809. [PubMed] [Google Scholar]

49. Moon HJ, Jung I, Park SJ, et al. Comparison of cancer yields and diagnostic performance of screening mammography vs. supplemental screening ultrasound in 4394 women with average risk for breast cancer. Ultraschall Med. 2015;36:255–263. [PubMed] [Google Scholar]

50. Choi WJ, Cha JH, Kim HH, et al. Comparison of automated breast volume scanning and hand- held ultrasound in the detection of breast cancer: An analysis of 5,566 patient evaluations. Asian Pac J Cancer Prev. 2014;15:9101–9105. [PubMed] [Google Scholar]

51. Jeh SK, Kim SH, Choi JJ, et al. Comparison of automated breast ultrasonography to handheld ultrasonography in detecting and diagnosing breast lesions. Acta Radiol. 2016;57:162–169. [PubMed] [Google Scholar]

52. Thigpen D, Kappler A, Brem R: The role of ultrasound in screening dense breasts-a review of the literature and practical solutions for implementation. Diagnostics (Basel) 10.3390/diagnostics8010020. [PMC free article] [PubMed] [Google Scholar]

53. Rebolj M, Assi V, Brentnall A, et al. Addition of ultrasound to mammography in the case of dense breast tissue: Systematic review and meta-analysis. Br J Cancer. 2018;118:1559–1570. [PMC free article] [PubMed] [Google Scholar]

54. Loving VA, DeMartini WB, Eby PR, et al. Targeted ultrasound in women younger than 30 years with focal breast signs or symptoms: Outcomes analyses and management implications. AJR Am J Roentgenol. 2010;195:1472–1477. [PubMed] [Google Scholar]

55. Birnbaum JK, Duggan C, Anderson BO, et al. Early detection and treatment strategies for breast cancer in low-income and upper middle-income countries: A modelling study. Lancet Glob Health. 2018;6:e885–e893. [PMC free article] [PubMed] [Google Scholar]

56. Silber JH, Rosenbaum PR, Ross RN, et al. Disparities in breast cancer survival by socioeconomic status despite medicare and medicaid insurance. Milbank Q. 2018;96:706–754. [PMC free article] [PubMed] [Google Scholar]

57. Shyyan R, Masood S, Badwe RA, et al. Breast cancer in limited-resource countries: Diagnosis and pathology. Breast J. 2006;12(suppl 1):S27–S37. [PubMed] [Google Scholar]

58. Galukande M, Kiguli-Malwadde E. Rethinking breast cancer screening strategies in resource-limited settings. Afr Health Sci. 2010;10:89–92. [PMC free article] [PubMed] [Google Scholar]

59. Dickerson LK, Rositch AF, Lucas S, et al. Pilot educational intervention and feasibility assessment of breast ultrasound in rural South Africa. J Glob Oncol. 2017;3:502–508. [PMC free article] [PubMed] [Google Scholar]

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