Supplemental Breast US Screening in Women with a Personal History of Breast Cancer: A Matched Cohort Study
Soo‐Yeon Kim, Nariya Cho, Soo Yeon Kim, Yunhee Choi, Eun Sil Kim, Su Min Ha, Su Hyun Lee, Jung Min Chang, Woo Kyung Moon
Abstract
Background There is limited research on supplemental screening breast US in women with a personal history of breast cancer (PHBC). Purpose To compare the performance of supplemental screening breast US in women with and women without a PHBC by using a matched cohort. Materials and Methods Consecutive asymptomatic women who underwent radiologist-performed supplemental breast US and mammography between January 2013 and December 2013 at a tertiary referral university hospital were retrospectively identified. Inclusion criteria were negative or benign findings at mammography, follow-up data for at least 1 year, first cancer stage of 0 to II in women with a PHBC, and incidence screening in women without a PHBC. The two groups were matched 1:1 according to age and breast density. Performance measures were compared with McNemar test, generalized estimating equation, or penalized likelihood logistic regression. Results A total of 3226 women with a PHBC were matched with 3226 women without a PHBC (mean age ± standard deviation, 52 years ± 9; mammographic breast density, fatty in 603 and dense in 2623). Fourteen cancers (six screen-detected, eight interval cancers) were found in women with a PHBC and 13 cancers (12 screen-detected, one interval cancer) in women without a PHBC. Supplemental US in women with a PHBC compared with women without a PHBC showed lower sensitivity (43% [95% confidence interval {CI}: 18%, 71%; six of 14 cancers] vs 92% [95% CI: 64%, 100%; 12 of 13 cancers]; P = .03), higher interval cancer rates (2.5 [95% CI: 1.1, 4.9; eight of 3226 women] vs 0.3 [95% CI: 0, 1.7; one of 3226 women] per 1000; P = .02), and higher specificity (92.8% [95% CI: 91.9%, 93.7%; 2982 of 3212 women] vs 89.3% [95% CI: 88.2%, 90.4%; 2870 of 3213 women]; P < .001), respectively. Conclusion Supplemental US screening in women with a personal history of breast cancer had lower sensitivity and higher interval cancer rate but higher specificity relative to women without a personal history of breast cancer. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Lee and Lee in this issue.