Clinical imaging · 2026
Ultrasound correlation modifies malignancy risk of architectural distortion on digital mammography and tomosynthesis: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Ferre Romuald, Benefield Thad, Kuzmiak Cherie M
Аннотация
BACKGROUND: Architectural distortion (AD) on mammography is worked up with targeted ultrasound (US), yet how much a US correlate changes malignancy risk by digital mammography (DM) versus digital breast tomosynthesis (DBT) is unclear.
PURPOSE: Quantify malignancy risk of AD by modality and US correlation and compare DBT with DM.
METHODS: PRISMA/MOOSE review (PROSPERO CRD4201088536). Five databases (2010-2025) were searched for studies reporting histopathology of AD stratified by modality and US findings. Malignancy risks were pooled with mixed-effects logistic regression; risk differences (RD) with 95% CIs compared US-positive versus US-negative lesions and DBT versus DM.
RESULTS: Fourteen studies (1707 AD lesions) were included. For DM-detected AD, malignancy risk was 50.7% (95% CI 9.7-90.8) with a US correlate and 26.5% (3.8-76.9) without (RD +24.1 points; 95% CI +9.8 to +38.5; p = 0.0010). For DBT-detected AD, risk was 56.8% (39.2-72.7) with a correlate and 20.3% (11.5-33.5) without (RD +36.4 points; 95% CI +27.3 to +45.6; p < 0.0001). Among US-positive lesions, DBT differed from DM (difference 16.7 points; p = 0.0017); among US-negative lesions, modality differences were not significant (difference 8.7 points; p = 0.097).
CONCLUSION: A targeted US correlate strongly increases malignancy risk for AD on both DM and DBT; absence of a correlate does not imply low risk by itself.
PURPOSE: Quantify malignancy risk of AD by modality and US correlation and compare DBT with DM.
METHODS: PRISMA/MOOSE review (PROSPERO CRD4201088536). Five databases (2010-2025) were searched for studies reporting histopathology of AD stratified by modality and US findings. Malignancy risks were pooled with mixed-effects logistic regression; risk differences (RD) with 95% CIs compared US-positive versus US-negative lesions and DBT versus DM.
RESULTS: Fourteen studies (1707 AD lesions) were included. For DM-detected AD, malignancy risk was 50.7% (95% CI 9.7-90.8) with a US correlate and 26.5% (3.8-76.9) without (RD +24.1 points; 95% CI +9.8 to +38.5; p = 0.0010). For DBT-detected AD, risk was 56.8% (39.2-72.7) with a correlate and 20.3% (11.5-33.5) without (RD +36.4 points; 95% CI +27.3 to +45.6; p < 0.0001). Among US-positive lesions, DBT differed from DM (difference 16.7 points; p = 0.0017); among US-negative lesions, modality differences were not significant (difference 8.7 points; p = 0.097).
CONCLUSION: A targeted US correlate strongly increases malignancy risk for AD on both DM and DBT; absence of a correlate does not imply low risk by itself.