Dynamic Electrical Impedance Scanning And Ultrasonography For Comparison Research Of Early Breast Tumor

Background and purpose: Breast cancer is the most common cancer all overthe world, the incidence is the highest malignant tumor of the women. In recentyears, it is thought by the world that the secondary prevention of breast cancer isthe most effective measure to improve survival of breast cancer. The secondaryprevention of breast cancer include breast self-examination and breast census.Currently there are two common breast census method： Ultrasonographyand Mammography，X-ray is radioactive. And the price fluctuation of Clinicalbreast ultrasound is huge, high resolution equipment values millions of Yuanactually，on the other hand the depends on the physician operating is higher andthe sensitivity for early minute lesion is lower. Britain and America have begunto implement breast cancer screening, and benefit.Our country also have carriedout "millions of women’s breast census engineering","national urban womenbreast cancer screening" and other projects, these screening project were notpopular, mainly because of radiation exposure, lower clinical sensitivity and stronger experience dependence. the advantage of Electrical impedancescanning imaging is noninvasive, no radiation and the lower price. The FourthMilitary Medical University researches the first breast EIS equipmentdomestically, and then studies the portable dynamic EIS equipment. Theresearch shows that: the advantage of EIS technology for breast cancer is highersensitivity, lower cost and the operator dependence, which is expected tobecome suitable for China’s national early breast lesions.The sensitivity of diagnosis ability and economic cost for the early breastdisease inspection, is the basis of breast screening scheme.In order to find theinspection way which provide a reference for breast screening scheme and tomeet high sensitivity requirement of the screening，our study analysis thesensitivity of dynamic EIS and the BUS with different clinical signs andsymptoms, looking for the evidence from combination diagnosis. At the sametime，we evaluate compare examination for breast early disease diagnosis on thebasic of ROC. It can provides reference to the breast screening program whichconforms to our country medical and health conditions.PartⅠ Sensitivity Analysis for Dynamic EIS and Ultrasonic of Early BreastCancerObjective：In order to find the inspection way which provide a reference forbreast screening scheme and to meet high sensitivity requirement of thescreening，our study analysis the sensitivity of dynamic EIS and the BUS withdifferent clinical symptoms such as different size, position, hardness, etc,looking for the evidence from combination diagnosisMethods: We have collected67cases of breast cancer patients in XiJingHospital from December2009to December2010, the gold standard ispathological results. Electrical impedance instrument is Care-scan5000, the frequency is100-200KHZ. Ultrasound examination instrument is ATL HDI-5000, frequency for5-12MHZ. It is calculated by software SPSS13.0statistically, the rate is computed by chi-square test.Result：1. The Sensitivity Effect of Dynamic EIS and Ultrasonic for Tumor SizeWhen the size is <1.0cm，the sensitivity of dynamic EIS is higher thanultrasound (85%>65%), they are significant difference;When the size is1.0-2.0cm, the sensitivity of dynamic EIS and ultrasound are no significantdifference (P>0.05).2. The Sensitivity Effect of Dynamic EIS and Ultrasonic for Tumor positionWhen the position is nipple areola area, the sensitivity dynamic EIS is lowerthan the ultrasound (75%<87.5%), they are significant difference (P <0.05);When the position is the quadrant, inner quadrant, the sensitivity ofdynamic EIS is higher than the ultrasound (88.9%>81.5%,87.5%>81.3%),they are no significant difference (P>0.05);3. The Sensitivity Effect of Dynamic EIS and Ultrasonic for Tumor hardnessWhen the hardness is cystic, the sensitivity of dynamic EIS is higher thanthe ultrasound (83.3%>79.2%), they are no significant difference (P>0.05);When the hardness is solid, the sensitivity of dynamic EIS is higher thanthe ultrasound (88.4%>81.4%), they are no significant difference (P>0.05).Conclusion: The size does not affect the sensitivity of the dynamic EIS, theposition does not affect the sensitivity of the ultrasound，and the hardness is notinfluence the sensitivity both of them.The sensitivity of the dynamic EIS and theultrasound is different under different clinical signs.They can show differentpathological properties of breast early changes, they are complementary.PartⅡ Diagnosis ability research of dynamic EIS, ultrasound and Combination diagnosis of early breast tumourObjective： we evaluate compare examination for breast early diseasediagnosis on the basic of ROC. It can provides reference to the breast screeningprogram which conforms to our country medical and health conditions.Methods:We have collected130cases of breast patients in XiJing Hospitalfrom April2010to April2012, the gold standard is pathological results.Electrical impedance instrument is Care-scan5000, the frequency is100-200KHZ. Ultrasound examination instrument is ATL HDI-5000, frequency for5-12MHZ. Combination diagnosis is a multi-stage classification, according tothe clarity of the diagnosis. It is calculated by software SPSS13.0statistically,the rate is computed by chi-square test.Results: In all130cases of lesions, the sensitivity of dynamic EIS is higherthan ultrasonic, they are no significant difference;the Sensitivity of theCombination diagnosis is higher than the Separate diagnosis, and they aresignificant difference. the Specificity of Separate diagnosis，and Combinationdiagnosis are no significant difference for both dynamic EIS and ultrasonic.According to the ROC, the diagnosibility of dynamic EIS, ultrasonic andCombination diagnosis is higher (Aultrasonic=0.808>0.7, AEIS=0.815>0.7, ACombination=0.901>0.7). the Diagnosis ability of dynamic EIS and ultrasonic isno significant difference separately (Aultrasonic=0.808, AEIS=0.815, P2,3>0.05). the Diagnosis ability of Separate diagnosis is lower than combinationdiagnosis, they are significant difference (Acom=0.901, Aultrasonic=0.808, AEIS=0.815, P2,3>0.05, P1.2<0.05, P <0.05)Conclusion: Separate diagnosis ability of dynamic EIS and ultrasound is nosignificant difference for early breast cancer; Diagnosis ability of combination ishigher than separate diagnosis for early breast cancer. When resources is rich, combination diagnosis ability is much higher. But when resource is scarcity,diagnosis ability of dynamic EIS is not inferior to ultrasonic, the cost andexperience dependence are less than ultrasonic，It can provides reference to thebreast screening program which conforms to our country medical and healthconditions.