1. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women
- Author
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Jing Ma, R. Huang, Jun Jiang, Y. Zhou, Hongchuan Jiang, H. Liao, B. Li, S. Li, N. Shen, Y. Xu, Zhimin Shao, C. Yu, S. Han, Bao Ning Zhang, Y. Shi, S. Shen, X. Duan, Jin Zhang, and Qiang Sun
- Subjects
Adult ,Cancer Research ,medicine.medical_specialty ,China ,mammography ,Breast Neoplasms ,Risk Assessment ,law.invention ,Breast cancer screening ,Breast cancer ,breast cancer ,Randomized controlled trial ,law ,Risk Factors ,Surveys and Questionnaires ,cost ,medicine ,Mammography ,Humans ,Ultrasonics ,Stage (cooking) ,Early Detection of Cancer ,Ultrasonography ,Gynecology ,medicine.diagnostic_test ,Obstetrics ,business.industry ,ultrasound ,screening ,Ultrasound ,Case-control study ,Cancer ,medicine.disease ,Oncology ,Case-Control Studies ,Clinical Study ,Female ,business ,Follow-Up Studies - Abstract
Background Chinese women tend to have small and dense breasts and ultrasound is a common method for breast cancer screening in China. However, its efficacy and cost comparing with mammography has not been evaluated in randomised trials. Methods At 14 breast centres across China during 2008-2010, 13 339 high-risk women aged 30-65 years were randomised to be screened by mammography alone, ultrasound alone, or by both methods at enrollment and 1-year follow-up. Results A total of 12 519 and 8692 women underwent the initial and second screenings, respectively. Among the 30 cancers (of which 15 were stage 0/I) detected, 5 (0.72/1000) were in the mammography group, 11 (1.51/1000) in the ultrasound group, and 14 (2.02/1000) in the combined group (P=0.12). In the combined group, ultrasound detected all the 14 cancers, whereas mammography detected 8, making ultrasound more sensitive (100 vs 57.1%, P=0.04) with a better diagnostic accuracy (0.999 vs 0.766, P=0.01). There was no difference between mammography and ultrasound in specificity (100 vs 99.9%, P=0.51) and positive predictive value (72.7 vs 70.0%; P=0.87). To detect one cancer, the costs of ultrasound, mammography, and combined modality were $7876, $45 253, and $21 599, respectively. Conclusions Ultrasound is superior to mammography for breast cancer screening in high-risk Chinese women.
- Published
- 2015