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Research article
Yubei Huang
Tianjin Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6299-7112
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background To investigate the performance of primary ultrasound (P-US) screening for breast cancer, and that of supplemental ultrasound (S-US) screening for breast cancer after negative mammography (MAM).
Methods Electronic databases (PubMed, Scopus, Web of Science, and Embase) were systematically searched to identify relevant studies published between January 2003 and May 2018. Only high-quality or fair-quality studies reporting any of the following performance values for P-US or S-US screening were included: sensitivity, specificity, cancer detected rate (CDR), recall rate (RR), biopsy rate (BR), proportion of invasive cancers among screening-detected cancers (ProIC), and proportion of node-negative cancers among screening-detected invasive cancers (ProNNIC).
Results Twenty-three studies were included, including 12 studies in which S-US screening was used after negative MAM and 11 joint screening studies in which both primary MAM (P-MAM) and P-US were used. Meta-analyses revealed that S-US screening could detect 96% [95% confidential intervals (CIs): 82% to 99%] of occult breast cancers missed by MAM and identify 93% (95% CIs: 89% to 96%) of healthy women, with a CDR of 3.0/1000 (95%CIs: 1.8/1000 to 4.6/1000), RR of 8.8% (95%CIs: 5.0% to 13.4%), BR of 3.9% (95%CIs: 2.7% to 5.4%), ProIC of 73.9% (95%CIs: 49.0% to 93.7%), and ProNNIC of 70.9% (95%CIs: 46.0% to 91.6%). Compared with P-MAM screening, P-US screening led to the recall of significantly more women with positive screening results [1.5% (95%CIs:0.6% to 2.3%), P =0.001] and detected significantly more invasive cancers [16.3% (95%CIs: 10.6% to 22.1%), P < 0.001]. However, there were no significant differences for other performance measures between the two screening methods, including sensitivity, specificity, CDR, BR, and ProNNIC.
Conclusions Current evidence suggests that S-US screening could detect occult breast cancers missed by MAM. P-US screening has shown to be comparable to P-MAM screening in women with dense breasts in terms of sensitivity, specificity, cancer detection rate, and biopsy rate, but with higher recall rates and higher detection rates for invasive cancers.
Keywords
breast cancer, screening, ultrasonography, mammography, supplemental
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CURRENT STATUS: Published
View the published article at BMC Cancer.
Version 4
Posted 25 Mar, 2020
No community comments so far
Reviewer #1 agreed
On 20 Apr, 2020
Reviewers invited
Invitations sent on 15 Apr, 2020
Editor assigned
On 25 Mar, 2020
Editor invited
On 24 Mar, 2020
Submission checks complete
On 23 Mar, 2020
No comments provided
Editorial decision: Major revision
On 12 Mar, 2020
Review #1 received
Received 11 Mar, 2020
Review #2 received
Received 05 Mar, 2020
Reviewer #2 agreed
On 14 Feb, 2020
Reviewer #1 agreed
On 13 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 29 Jan, 2020
Submission checks complete
On 28 Jan, 2020
Editor invited
On 28 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 10 Jan, 2020
Review #1 received
Received 30 Dec, 2019
Review #2 received
Received 26 Dec, 2019
Reviewer #2 agreed
On 04 Dec, 2019
Reviewer #1 agreed
On 02 Dec, 2019
Reviewers invited
Invitations sent on 02 Dec, 2019
Editor assigned
On 28 Nov, 2019
Submission checks complete
On 27 Nov, 2019
Editor invited
On 27 Nov, 2019
No comments provided
Editorial decision: Major revision
On 15 Nov, 2019
Review #2 received
Received 13 Nov, 2019
Review #1 received
Received 29 Oct, 2019
Reviewer #1 agreed
On 30 Sep, 2019
Reviewer #2 agreed
On 30 Sep, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Submission checks complete
On 01 Sep, 2019
Editor assigned
On 28 Aug, 2019
Editor invited
On 27 Aug, 2019
First submitted
On 26 Aug, 2019
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PDF Downloads: ...
HTML Views: ...
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Cancer.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yubei Huang
Tianjin Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6299-7112
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cancer.
Version 4
Posted 25 Mar, 2020
No community comments so far
Reviewer #1 agreed
On 20 Apr, 2020
Reviewers invited
Invitations sent on 15 Apr, 2020
Editor assigned
On 25 Mar, 2020
Editor invited
On 24 Mar, 2020
Submission checks complete
On 23 Mar, 2020
No comments provided
Editorial decision: Major revision
On 12 Mar, 2020
Review #1 received
Received 11 Mar, 2020
Review #2 received
Received 05 Mar, 2020
Reviewer #2 agreed
On 14 Feb, 2020
Reviewer #1 agreed
On 13 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 29 Jan, 2020
Submission checks complete
On 28 Jan, 2020
Editor invited
On 28 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 10 Jan, 2020
Review #1 received
Received 30 Dec, 2019
Review #2 received
Received 26 Dec, 2019
Reviewer #2 agreed
On 04 Dec, 2019
Reviewer #1 agreed
On 02 Dec, 2019
Reviewers invited
Invitations sent on 02 Dec, 2019
Editor assigned
On 28 Nov, 2019
Submission checks complete
On 27 Nov, 2019
Editor invited
On 27 Nov, 2019
No comments provided
Editorial decision: Major revision
On 15 Nov, 2019
Review #2 received
Received 13 Nov, 2019
Review #1 received
Received 29 Oct, 2019
Reviewer #1 agreed
On 30 Sep, 2019
Reviewer #2 agreed
On 30 Sep, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Submission checks complete
On 01 Sep, 2019
Editor assigned
On 28 Aug, 2019
Editor invited
On 27 Aug, 2019
First submitted
On 26 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cancer.
Background To investigate the performance of primary ultrasound (P-US) screening for breast cancer, and that of supplemental ultrasound (S-US) screening for breast cancer after negative mammography (MAM).
Methods Electronic databases (PubMed, Scopus, Web of Science, and Embase) were systematically searched to identify relevant studies published between January 2003 and May 2018. Only high-quality or fair-quality studies reporting any of the following performance values for P-US or S-US screening were included: sensitivity, specificity, cancer detected rate (CDR), recall rate (RR), biopsy rate (BR), proportion of invasive cancers among screening-detected cancers (ProIC), and proportion of node-negative cancers among screening-detected invasive cancers (ProNNIC).
Results Twenty-three studies were included, including 12 studies in which S-US screening was used after negative MAM and 11 joint screening studies in which both primary MAM (P-MAM) and P-US were used. Meta-analyses revealed that S-US screening could detect 96% [95% confidential intervals (CIs): 82% to 99%] of occult breast cancers missed by MAM and identify 93% (95% CIs: 89% to 96%) of healthy women, with a CDR of 3.0/1000 (95%CIs: 1.8/1000 to 4.6/1000), RR of 8.8% (95%CIs: 5.0% to 13.4%), BR of 3.9% (95%CIs: 2.7% to 5.4%), ProIC of 73.9% (95%CIs: 49.0% to 93.7%), and ProNNIC of 70.9% (95%CIs: 46.0% to 91.6%). Compared with P-MAM screening, P-US screening led to the recall of significantly more women with positive screening results [1.5% (95%CIs:0.6% to 2.3%), P =0.001] and detected significantly more invasive cancers [16.3% (95%CIs: 10.6% to 22.1%), P < 0.001]. However, there were no significant differences for other performance measures between the two screening methods, including sensitivity, specificity, CDR, BR, and ProNNIC.
Conclusions Current evidence suggests that S-US screening could detect occult breast cancers missed by MAM. P-US screening has shown to be comparable to P-MAM screening in women with dense breasts in terms of sensitivity, specificity, cancer detection rate, and biopsy rate, but with higher recall rates and higher detection rates for invasive cancers.
Figure 1
Figure 2
Figure 3
Figure 4
This is a list of supplementary files associated with this preprint. Click to download.
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