ArticleFrontiers in oncology2025
Risk stratification by ultrasound and mammography for screen-detected non-palpable breast cancer in Chinese women.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Mammography (MG) and ultrasound (US) are currently the 'real-world' initial imaging tests for breast cancer in China. Previously, we demonstrated that US and MG detected non-palpable breast cancer (NPBC) had similar survival. This study was performed to validate the hypothesis whether MG+/US- NPBC could be taken as ultra-low risk cancer. Method: From 2015-2018, 3,113 consecutive patients received biopsy with initial positive screening. Among them, 2,591 US positive patients underwent US-guided biopsy. Meanwhile, 371 MG+/US- patients underwent MG-guided biopsy. Clinical characteristics, treatment and 5-year disease free survival (DFS) and overall survival (OS) were analyzed. Prognostic factors of NPBC were identified. Results: We identified 419 cases of US+/MG-, 225 cases of US+/MG+, and 118 cases of US-/MG+ breast cancers, yielding positive predictive values (PPVs) of 21.6%, 34.7%, and 22.6%, respectively. Notably, among NPBC with US-/MG+ features, a significantly higher proportion exhibited DCIS (50.8%, P<0.001), multifocality (18.5%, P = 0.003), underwent breast-conserving surgeries (66.1%, P<0.001), and did not receive chemotherapy or radiotherapy (64.4% & 66.9%, P<0.001 & P = 0.032). MG+/US- patients demonstrated improved DFS compared to US+/AnyMG (P = 0.035), with no significant difference in OS (P = 0.48). Univariate and multivariate Cox regression analysis identified age, TNM stage, lymphovascular invasion (LVI), and estrogen receptor (ER) status as significant DFS predictors(P<0.05), with ER status alone being significant for OS (P = 0.002). Conclusion: MG
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