Limitations of mammography in the diagnosis of breast diseases compared with ultrasonography: a single-center retrospective analysis of 274 cases

BACKGROUND The aim of this study is to compare X-ray mammography (MG) and ultrasonography (US) in the diagnosis of breast diseases in Chinese women. METHODS We retrospectively analyzed X-ray mammograms of 274 patients with US and surgical/pathological results of breast diseases diagnosed at The Second Affiliated Hospital of Anhui Medical University (Hefei, China) between March 2011 and November 2014. The MG and US data were compared to surgical records using the results from post-surgical pathological examinations as the gold standard. RESULTS The overall sensitivity, specificity, accuracy, false-positive, false-negative, positive predictive value, and negative predictive value for the detection of breast cancer were 88.5%, 57.9%, 73.7%, 42.1%, 11.5%, 69.2%, and 82.5%, respectively, for MG and 95.9%, 66.7%, 81.8%, 33.3%, 4.1%, 75.5%, and 93.8%, respectively, for US. Of the 274 cases, lesion size by MG agreed with surgery in 133 (48.5%) patients compared with 216 (78.8%) by US (P < 0.01). Lesion location by MG agreed with surgery in 146 (53.3%) patients compared with 257 (93.8%) by US (P < 0.01). These values were then stratified according to age, menstrual status, breast density, and breast volume, and the agreement rates of MG with surgery were lower than that of US (all P < 0.01), except when the lesion size was >5 cm (P > 0.05). CONCLUSIONS US was better than MG in the preoperative evaluation of breast diseases of Chinese women. These results suggest that US could be more useful for detecting breast lesions in China, especially for younger women with dense breasts.