Abstract
Objective: Focal asymmetric densities (FAD) observed in mammography (MMG) are also seen in normal breasts so their positive predictive value (PPV) is low and the false positive (FP) rate is high, making accuracy management difficult for health check-up facilities. In examinees deemed to require more detailed examination due to FAD in screening MMG, we clarified the extent to which combined evaluation by breast ultrasonography (US) raised the PPV of FAD in order to determine the effectiveness of such combined evaluation as a way of reducing excessive judgments of “requiring more detailed examination” due to FAD.
Methods: We focused on 204 persons told that they required more detailed examination on the basis of undergoing population-based or opportunistic MMG screening at our facility from January to December 2013. The subjects of this study were the 171 persons who actually underwent such examination. We obtained PPV from their medical records.
Results: Lesions were found in US conducted at the location of FAD for 73 subjects (42.7%), and biopsies were required for 13 of them. Breast cancer was determined in 6 of these subjects. The PPV for FAD by MMG alone was 3.5%. Additional judgment by means of US raised the PPV to 46.2%.
Conclusion: The use of US for additional evaluation of FAD findings in MMG can raise the PPV for FAD, enabling the FP rate to be reduced and the amount of excessive further detailed examination due to FAD to be reduced. Examinees are affected psychologically by a FP result and this impact could also be reduced.
