The Value Of MRI, B-ultrasound And Mammography For Breast Tumor

Breast cancer is one of the most common cancers in women. Early and exact diagnosis is important to the patients. The key point of clinical work is to differentiate the benign and the malignant breast tumor. Mammography and B-ultrasonography are traditional imaging techniques, while MRI have developed rapidly during these years. The question is which imaging technique is best for the patient.1 PurposeTo evaluate the diagnostic accuracy of MRI, B-ultrasound and mammography for breast tumor, to discuss the best imaging technique.2 Materials and MethodsRetrospective study the 189 patients who come to surgical oncology of Sir Runrun Shaw hospital from Jan.2003 to Sep.2010. All of patients took MRI, Mammography and B-ultrasonography in two weeks before surgery. Compare the three methods on the following aspects:the sensitivity, Specificity, positive predictive value, negative predictive value, accuracy, detection rate of multi-primary tumor and range of tumor, with the pathology of tissues as the gold standard. SPSS 13.0 for Windows is used in the statistics analysis, while the methods include T test and chi square test. 3 ResultsAll of the 189 patients are females, aging from 15 to 79 years old, with the median age of 47 years old. It is proved by the post surgical pathology that 86 patients aged from 35 to 79 years old with the median age of 52 years old are malignant. The remainders aged from 15 to 73 years old with the median age of 44 years old are benign.MRI has its advantages on sensitivity, respectively 93.0%vs 76.7%and 93.0%vs 55.8%, comparing with B-ultrasonography and Mammography. Meanwhile, MRI has its disadvantages on Specificity,70.0%vs 90.5%, especially comparing with Mammography. There are no significant difference on accuracy among these methods. If those methods are combined in tests, the Specificity will be significantly improved (70%vs 95.1%) comparing to MRI, however there is no significant improvement on sensitivity (93%vs 94.2%),The preoperative diameter of tumor tested by B-ultrasound is 1.61±0.61 cm, smaller than postoperative pathologic result 2.38±0.9 cm. The difference is significant. The preoperative diameter of tumor tested by Mammography is 1.72±0.82 cm, smaller than postoperative pathologic result 2.56±0.9 cm. The difference is significant too. The preoperative diameter of tumor tested by MRI is 2.40±0.79 cm, similar to postoperative pathologic result 2.49±0.96 cm. The difference is not significant.Neither B-ultrasonography nor Mammography detect the multi-primary tumor in all of the breast cancer cases, while MRI detects 10 cases of multi-primary tumor. The detection rate of B-ultrasonography, Mammography and MRI is respectively 0,0, 11.6%. The difference is significant.4 discussions and conclusionsThe breast MRI is of the best sensitivity but the worst specificity, which can be improved by the combination of these three methods. The advantages of Mammography are conveniently workable, cheaper than MRI and Mammography, and with a certain sensitivity. The sensitivity and specificity of B-ultrasonography is between MRI and Mammography. And c is conveniently workable, with no damage or pain and can test repeatedly. So B-ultrasonography and Mammography can be combined well to screen the breast diseases as the first choice.Comparing to B-ultrasonography and Mammography, MRI has an obvious advantage on evaluating the diameter of the preoperative tumor because of its superb ability on imagery and high resolution on soft tissues. Thus, MRI can evaluate the tumor staging precisely and be beneficial to determining the protocols.Comparing to B-ultrasonography and Mammography, MRI has an obvious advantage on detect the multi-primary tumor. When it comes to the Diagnosis and determining the protocols, MRI has great clinical significances for patients who want to conserve their breasts.