Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis
<b>Purpose</b>: The purpose of this meta-analysis is to investigate the effectiveness of supplementing screening mammography with three-dimensional automated breast ultrasonography (3D ABUS) in improving breast cancer detection rates in asymptomatic women with dense breasts. <b>Mat...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/12/1683 |
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| author | Gianluca Gatta Francesco Somma Celestino Sardu Marco De Chiara Raffaella Massafra Annarita Fanizzi Daniele La Forgia Vincenzo Cuccurullo Francesco Iovino Alfredo Clemente Raffaele Marfella Graziella Di Grezia |
| author_facet | Gianluca Gatta Francesco Somma Celestino Sardu Marco De Chiara Raffaella Massafra Annarita Fanizzi Daniele La Forgia Vincenzo Cuccurullo Francesco Iovino Alfredo Clemente Raffaele Marfella Graziella Di Grezia |
| author_sort | Gianluca Gatta |
| collection | DOAJ |
| description | <b>Purpose</b>: The purpose of this meta-analysis is to investigate the effectiveness of supplementing screening mammography with three-dimensional automated breast ultrasonography (3D ABUS) in improving breast cancer detection rates in asymptomatic women with dense breasts. <b>Materials and Methods:</b> We conducted a thorough review of scientific publications comparing 3D ABUS and mammography. Articles for inclusion were sourced from peer-reviewed journal databases, namely MEDLINE (PubMed) and Scopus, based on an initial screening of their titles and abstracts. To ensure a sufficient sample size for meaningful analysis, only studies evaluating a minimum of 20 patients were retained. Eligibility for evaluation was further limited to articles written in English. Additionally, selected studies were required to have participants aged 18 or above at the time of the study. We analyzed 25 studies published between 2000 and 2021, which included a total of 31,549 women with dense breasts. Among these women, 229 underwent mammography alone, while 347 underwent mammography in combination with 3D ABUS. The average age of the women was 50.86 years (±10 years standard deviation), with a range of 40–56 years. In our efforts to address and reduce bias, we applied a range of statistical analyses. These included assessing study variation through heterogeneity assessment, accounting for potential study variability using a random-effects model, exploring sources of bias via meta-regression analysis, and checking for publication bias through funnel plots and the Egger test. These methods ensured the reliability of our study findings. <b>Results:</b> According to the 25 studies included in this metanalysis, out of the total number of women, 27,495 were diagnosed with breast cancer. Of these, 211 were diagnosed through mammography alone, while an additional 329 women were diagnosed through the combination of full-field digital mammography (FFDSM) and 3D ABUS. This represents an increase of 51.5%. The rate of cancers detected per 1000 women screened was 23.25‰ (95% confidence interval [CI]: 21.20, 25.60; <i>p</i> < 0.001) with mammography alone. In contrast, the addition of 3D ABUS to mammography increased the number of tumors detected to 20.95‰ (95% confidence interval [CI]: 18.50, 23; <i>p</i> < 0.001) per 1000 women screened. <b>Discussion:</b> Even though variability in study results, lack of long-term outcomes, and selection bias may be present, this systematic review and meta-analysis confirms that supplementing mammography with 3D ABUS increases the accuracy of breast cancer detection in women with ACR3 to ACR4 breasts. Our findings suggest that the combination of mammography and 3D ABUS should be considered for screening women with dense breasts. <b>Conclusions:</b> Our research confirms that adding 3D automated breast ultrasound to mammography-only screening in patients with dense breasts (ACR3 and ACR4) significantly (<i>p</i> < 0.05) increases the cancer detection rate. |
| first_indexed | 2024-03-08T20:36:51Z |
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| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-08T20:36:51Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-699dfc6da991458889b1dc63d73ea5a92023-12-22T14:19:56ZengMDPI AGJournal of Personalized Medicine2075-44262023-12-011312168310.3390/jpm13121683Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and MetanalysisGianluca Gatta0Francesco Somma1Celestino Sardu2Marco De Chiara3Raffaella Massafra4Annarita Fanizzi5Daniele La Forgia6Vincenzo Cuccurullo7Francesco Iovino8Alfredo Clemente9Raffaele Marfella10Graziella Di Grezia11Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, ItalyU.O.C. Neurodiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, ItalyDepartment of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, ItalyDepartment of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, ItalyDepartment of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, ItalyDepartment of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, ItalyDepartment of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, ItalyDepartment of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, ItalyDepartment of Translational Medical Science, School of Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyDepartment of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, ItalyDepartment of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, ItalyRadiology Department, ASL Avellino, 83100 Avellino, Italy<b>Purpose</b>: The purpose of this meta-analysis is to investigate the effectiveness of supplementing screening mammography with three-dimensional automated breast ultrasonography (3D ABUS) in improving breast cancer detection rates in asymptomatic women with dense breasts. <b>Materials and Methods:</b> We conducted a thorough review of scientific publications comparing 3D ABUS and mammography. Articles for inclusion were sourced from peer-reviewed journal databases, namely MEDLINE (PubMed) and Scopus, based on an initial screening of their titles and abstracts. To ensure a sufficient sample size for meaningful analysis, only studies evaluating a minimum of 20 patients were retained. Eligibility for evaluation was further limited to articles written in English. Additionally, selected studies were required to have participants aged 18 or above at the time of the study. We analyzed 25 studies published between 2000 and 2021, which included a total of 31,549 women with dense breasts. Among these women, 229 underwent mammography alone, while 347 underwent mammography in combination with 3D ABUS. The average age of the women was 50.86 years (±10 years standard deviation), with a range of 40–56 years. In our efforts to address and reduce bias, we applied a range of statistical analyses. These included assessing study variation through heterogeneity assessment, accounting for potential study variability using a random-effects model, exploring sources of bias via meta-regression analysis, and checking for publication bias through funnel plots and the Egger test. These methods ensured the reliability of our study findings. <b>Results:</b> According to the 25 studies included in this metanalysis, out of the total number of women, 27,495 were diagnosed with breast cancer. Of these, 211 were diagnosed through mammography alone, while an additional 329 women were diagnosed through the combination of full-field digital mammography (FFDSM) and 3D ABUS. This represents an increase of 51.5%. The rate of cancers detected per 1000 women screened was 23.25‰ (95% confidence interval [CI]: 21.20, 25.60; <i>p</i> < 0.001) with mammography alone. In contrast, the addition of 3D ABUS to mammography increased the number of tumors detected to 20.95‰ (95% confidence interval [CI]: 18.50, 23; <i>p</i> < 0.001) per 1000 women screened. <b>Discussion:</b> Even though variability in study results, lack of long-term outcomes, and selection bias may be present, this systematic review and meta-analysis confirms that supplementing mammography with 3D ABUS increases the accuracy of breast cancer detection in women with ACR3 to ACR4 breasts. Our findings suggest that the combination of mammography and 3D ABUS should be considered for screening women with dense breasts. <b>Conclusions:</b> Our research confirms that adding 3D automated breast ultrasound to mammography-only screening in patients with dense breasts (ACR3 and ACR4) significantly (<i>p</i> < 0.05) increases the cancer detection rate.https://www.mdpi.com/2075-4426/13/12/1683automatized breast ultrasonographybreast cancer screeningbreast |
| spellingShingle | Gianluca Gatta Francesco Somma Celestino Sardu Marco De Chiara Raffaella Massafra Annarita Fanizzi Daniele La Forgia Vincenzo Cuccurullo Francesco Iovino Alfredo Clemente Raffaele Marfella Graziella Di Grezia Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis Journal of Personalized Medicine automatized breast ultrasonography breast cancer screening breast |
| title | Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis |
| title_full | Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis |
| title_fullStr | Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis |
| title_full_unstemmed | Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis |
| title_short | Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis |
| title_sort | automated 3d ultrasound as an adjunct to screening mammography programs in dense breast literature review and metanalysis |
| topic | automatized breast ultrasonography breast cancer screening breast |
| url | https://www.mdpi.com/2075-4426/13/12/1683 |
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