Comparison of Diagnostic Efficiency of Breast Cancer Imaging in Chinese Women: Digital Mammography, Ultrasound, MRI, and Combinations of These Modalities

The primary objective of this study was to compare diagnostic efficiency of digital mammography (DMAM), ultrasound (US), magnetic resonance imaging (MRI) and combinations of these modalities in diagnosing breast benign and malignant lesions in Chinese female patients. 85 patients with clinically suspected breast cancer from December 2011 to March 2013 were enrolled in this study. All patients successfully underwent DMAM, US and MRI. The diagnostic performance of each imaging modality and the different combinations were respectively compared with pathological reports as the gold standard. Of the 96 breast lesions in 85 patients, 39 malignant and 57 benign tumors were found. DMAM detected 30 (76.9%) malignant tumors; US, 32 (82.1%); and MRI, 34 (87.2%). DMAM plus US recognized 36 (92.3%); DMAM plus MRI, 37 (94.9%); DMAM plus US and MRI, 38 (97.4%). The sensitivity were significantly higher for MRI alone than for DMAM or US alone (p < 0.05). Besides, MRI can detect most of small breast tumor (<= 2 cm), which is significantly higher than DMAM and US (p < 0.05). The combination of three imaging modalities significantly improved the diagnostic efficiency, the highest sensitivity was achieved by DMAM plus US and MRI, whereas its specificity (59.6%) was the lowest in all combined imaging modalities (DMAM plus US, 82.5%; DMAM plus MRI, 70.2%). Using a single imaging modality is not enough for breast tumor accurate diagnosis sometimes, and combined imaging protocol is needed. A combination of DMAM and US can provide more sensitivity than one imaging method alone for diagnosis of breast cancer in Chinese female patients, and it should be routinely used as a first-line imaging protocol, taking account of its performance and cost. MRI can diagnose breast cancer more accurately than DMAM or US alone, especially for small breast cancer.