Objective To systematically review the clinical value of color Doppler ultrasonic for diagnosing female breast cancer. Methods We electronicaaly searched the databases including The Cochrane Library (Issue 2, 2013), EMbase, PubMed, CNKI, WanFang Data, MedaLink ,VIP and CBM for diagnostic tests on breast cancer diagnosed with color Doppler ultrasonic vs. with pathological biopsy (golden criteria) from 1982 to the March, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies according to QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity, specificity, positive likelihood radio, and negative likelihood radio. Heterogeneity test was performed and the summary receiver operating characteristic curve (SROC) was drawn for area under the curve (AUC). Results A total of 25 studies involving 3 274 patients were included. The results of meta-analysis showed that, SPE, SEN, +LR, −LR and DOR were (0.76, 95%CI 0.74 to 0.78), (0.80, 95%CI 0.78 to 0.82), (3.58, 95%CI 2.63 to 4.87), (0.28, 95%CI 0.22 to 0.35) and (13.76, 95%CI 8.47 to 22.36), respectively. The AUC of SROC curve was 0.865 7. Conclusion Current evidence shows that color Doppler ultrasonic has high sensitivity (80%) and high specificity (76%) in the diagnosis of high-frequency Ultrasound. The positive rate in the breast cancer group is 13.76 times as high as that in non-breast cancer, which indicates color Doppler ultrasonic has good diagnostic value for breast cancer.
ObjectiveTo investigate the methods and significances of the breast ultrasonographic breast imaging reporting and data system (BI-RADS) category 4 lesions divided into category 4a, 4b, and 4c, and to assess the risk of malig-nancy of lesions with BI-RADS category 4 in order to improve the accuracy of diagnosis. MethodsTwo hundred and eighty-eight breast lesions with BI-RADS category 4 confirmed by histopathology were collected. The ultrasonographic characteristics of benign and malignant lesions, containing the shape, aspect ration, margin, calcification, changes of the surrounding tissue, boundary, blood flow characteristics, internal echo, rear echo of the lesions, were comparatively anal-yzed, and the lesions with BI-RADS-US category 4 were divided into 4a, 4b, 4c according to these ultrasonographic charac-teristics and analyzed by statistics. ResultsThere were 192 malignant lesions and 96 benign lesions in the 288 breast lesions. There were statistical significances in the benign and malignant lesions with the shape, aspect ratio, margin, calci-fication, change of surrounding tissue, and boundary (P < 0.05), in other words, the proportion of these ultrasonographic characteristics were higher in the malignant lesions as compared with the benign lesions. But there were no significant differences of internal echo, rear echo, and blood flow characteristics between two lesions (P > 0.05). The positive predictive value of malignant tumor with BI-RADS category 4a, 4b, and 4c were 21.74%, 58.90%, and 91.78%, respectively, and there was significant difference (χ2=106.09, P=0.000). ConclusionsThe classification of breast lesions with BI-RADS category 4 is refined, it could more accurately assess the risk of benign and malignant breast masses. At the same time, it has an important clinical significance for diagnosis and treatment of benign and malignant breast masses.