Comparative performance of mammography, abbreviated-protocol breast magnetic resonance imaging (MRI), and full diagnostic protocol breast magnetic resonance imaging (MRI) in diagnosing early breast cancer.

AIM: The aim of the study is to compare the detection performance of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), breast magnetic resonance imaging protocol (BMRI-AP) and BMRI-full diagnostic protocol (FDP) for early breast cancer in different breast density types.

MATERIALS AND

METHODS

Based on the pathological results, the receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of different examination methods for breast cancer.

RESULTS

For dense breasts, the accuracy, sensitivity, and specificity of FFDM, DBT, BMRI-AP, and BMRI-FDP were, respectively, 82.7%, 88.9%, 94.1%, and 94.5% (P < 0.05); 83.0%, 89.8%, 94.2%, and 94.7% (P < 0.05); and 81.9%, 86.8%, 94.0%, and 94.0% (P < 0.05). The area under the curve (AUC) values for diagnosing early-stage breast cancer were 0.825, 0.883, 0.941, and 0.943, and there was no statistically significant difference between BMRI-AP and BMRI-FDP (P < 0.05). The AUC values for diagnosing early-stage breast cancer with BMRI-AP and BMRI-FDP were greater than those of FFDM and DBT (P < 0.05); the AUC for diagnosing early-stage breast cancer with DBT was greater than that of FFDM (P < 0.05). For nondense breasts, BMRI-FDP had the highest accuracy, at 95.0%, and sensitivity, at 94.1%. FFDM, DBT, and BMRI-AP showed equal performance (accuracy: 92.5%, sensitivity: 91.2%).

CONCLUSION

For dense breasts, the BMRI-FDP showed the best efficacy in diagnosing early breast cancer, followed by BMRI-AP, then DBT and finally FFDM. FFDM, DBT, BMRI-AP and BMRI-FDP performed equally well in non-dense breasts. Although the diagnostic effects of BMRI-AP and BMRI-FDP were comparable, there was still a possibility of missing some lesions that had regular shapes and early enhancement features but do not exhibit rapid enhancement. However, the proportion of such cases was very small (0.83% in this study).