Diagnostic Value of Color Doppler Ultrasonic for Female Breast Cancer: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Xiaoguang ¹ , PalidaPaerhati ¹ , ZHANG Yu ² ,  NadireTieliewuhan ¹

1. Ultrasound Diagnosis Medicine Center, The First Aiffliated Hospital of Xinjiang Medical University, Urumuqi 830054, China;2. Physical Check-ups and Health Management Center, The First Aiffliated Hospital of Xinjiang Medical University, Urumuqi 830054, China;

Corresponding author：

NadireTieliewuhan, Email: nadire607@163.com

Keywords：

Breast cancer; Ultrasound diagnosis; Systematic review; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.20130184

Video：

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Abstract Full text Figures/Tables Video References Cited by

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.

Citation： ZHANG Xiaoguang,PalidaPaerhati,ZHANG Yu,NadireTieliewuhan. Diagnostic Value of Color Doppler Ultrasonic for Female Breast Cancer: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(9): 1073-1079. doi: 10.7507/1672-2531.20130184 Copy

1.	Mandelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval and screen-detected cancers. Journal of the National Cancer Institute, 2000, 92(13): 1081-1087.
2.	Adler DD, Carson PL, Rubin JM, et al. Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings. Ultrasound in Medicine & Biology, 1990, 16(6): 553-559.
3.	Anderson BO, Shyyan R, Eniu A, et al. Breast cancer in limited-resource countries: an overview of the breast health global initiative 2005 guidelines. Breast J, 2006, 12 (Suppl 1): 3-15.
4.	Creager AJ, Madden CR, Bergman S, et al. Aneurysmal bonecyst: fine-needle aspriation findings in 23 patients with clinical and radiologic correlation. Am J Clin Pathol, 2007, 128(5): 740-745.
5.	李养敏, 杨梦玲, 千艳秋. 彩色多普勒超声对乳腺良恶性肿块的鉴别诊断价值. 实用医学影像杂志, 2008, 9(6): 390.
6.	Schulz-Wendtland R,Beck K,Aichinger U, et al. Ultrasound examination of the breast with 7.5 MHz and 13 MHZ-transdcers: scope for improving diagnostic accuracy in complementary breast diagnostics? Ultraschall Med, 2005, 26(3): 209-215.
7.	刁骧, 艾昌林, 秦莉, 等译. QUADAS的制定: 用于系统评价诊断性研究质量的工具. 中国循证医学杂志, 2007, 7(4): 296-306.
8.	张天嵩, 钟文昭. Meta-DiSc软件在诊断试验Meta分析中的应用. 循证医学, 2008, 8(2): 97-100.
9.	Habel LA, Capra AM, Oestreicher N, et al. Mammographic density in a multiethnic cohort. Menopause, 2007, 14(5): 891-899.
10.	王怀娥, 张宗欣, 尚延海, 等. 新型钼靶X线机与多普勒超声对乳腺结节的诊断价值. 医学影像学杂志, 2001,11(2): 89-93.
11.	张宏艳, 梁峰, 刘瑞祺. 临床查体、乳腺超声及X线检查诊断中国人乳腺癌的评价. 解放军医学杂志, 2007, 32(11): 1167-1170.
12.	赵红佳, 董宝玮, 许荣, 等. 超声造影定量分析在乳腺肿瘤诊断中的应用价值. 中华乳腺病杂志(电子版), 2008, 2(6): 634-640.
13.	蓝健君, 郭依廷, 周琼, 等. 钼靶X线、彩色多普勒超声对乳腺结节诊断的临床应用价值.中国中西医结合影像学杂志, 2008, 6(5): 358-360, 363.
14.	吴颖猛, 梁毅, 姜海明. 乳腺癌MRI与全数字化钼靶摄影及乳腺B超的对比研究. 中山大学学报, 2009, 30 (4S): 232-233.
15.	温悦. 超声、钼靶及MRI对乳腺疾病诊断的对比性分析. 河北医科大学, 2010.
16.	项洋锋. 磁共振、B超及钼靶对乳腺疾病的诊断价值. 浙江大学, 2010.
17.	徐煜佳, 曹霞. 乳腺肿块的三维超声诊断及其与钼靶X线的对比研究. 黑龙江医药科学, 2010, 33(5): 47-48.
18.	德杰, 李彩英, 冯平勇, 等. 数字钼靶X线摄影与彩色多普勒超声对乳腺肿块的诊断价值. 放射学实践, 2010, 25(1): 55-58.
19.	陈文清, 刘光洪, 郑进华, 等. 钼靶X线、高频彩超联合MRI在乳腺癌术前评估中的价值. 中国妇幼保健, 2010, 25(27): 3986-3987.
20.	夏晓天, 何萍青, 林燕苹, 等. 乳腺X线摄影、超声与MRI增强检查在乳腺疾病诊断中的比较. 外科理论与实践, 2010, 15(5): 473-476.
21.	丁勇俊, 何玉洁, 范晓芳, 等. ROC评价钼靶摄影、超声与磁共振增强在乳腺肿块良性诊断中的应用. 中国医学创新, 2009, 6(26): 149-151.
22.	夏长虹, 王莉, 陆建平, 等. 超声联合磁共振成像诊断乳腺癌与病理学对照研究. 中华医学超声杂志(电子版), 2011, 8(6): 1267-1271.
23.	赵丽. 钼靶、超声、钼靶和超声联合与MRI影像学在早期乳腺癌应用及价值探讨. 中国临床医学影像杂志, 2011, 22(10): 728-730.
24.	张秀梅, 李佳睿, 王刚, 等. 数字化钼靶、超声、MRI及MR扩散加权在老年乳腺肿瘤中的临床诊断价值. 中国老年病学杂志, 2011, 31(16): 3030-3032.
25.	尤厚成, 刘健, 尤楠, 等. 超声造影对乳腺良恶性肿块鉴别诊断的价值. 中国普外基础与临床杂志, 2011, 18(8): 861-865.
26.	鲍朝辉. 不同检查方法在乳腺癌诊断中的效果分析. 中外医学研究, 2011, 9(24): 60-61.
27.	张茂. 高频彩色多普勒超声诊断乳腺肿块的临床应用. 中外医疗, 2011, 11(5): 174-175.
28.	陈杰, 吴晓萍, 李旭霞, 等. 超声造影和彩色多普勒超声联合检查乳腺肿块的临床价值.医学影像学杂志, 2012, 22(2): 286-287.
29.	杨丽丽. 钼靶X线和彩色多普勒超声在乳腺肿块诊断中的应用. 新疆医科大学, 2012.
30.	Malur S, Wurdinger S, Moritz A, et al. Comparison of written reports of mammography for preoperative evaluation of breast lesions, with special emphasis on magnetic resonance mammography. Breast Cancer, 2001, 3(5): 55-60.
31.	Berg WA, Gutierrez L, NessAives MS, et al. Diagnostic accuracy of mammography, clinical examination, US and MR imaging in preoperative assessment of breast cancer. Radiology, 2004, 233(3): 830-849.
32.	Ozulker T, Ozulker F, Ozpacaci T, et al. The efficacy of 99mTc-MIBI scintimammography in the evaluation of breast lesions and auxiliary involvement: a comparison with X-rays mammography ultrasonography and magnetic resonance imagine. Hell J Nucl Med, 2010, 13(2): 144-149.
33.	Pediconi F, Catalano C, Roselli A, et al. The challenge of imagine dense breast parenchyma : magnetic resonance mammography the technique of choice? A comparative study with X-ray mammography and whole-breast ultrasound. Invest Radiol, 2009, 44(7): 412-421.
34.	Vassiou K, Kanavou T, Vlychou M, et al. Characterization of breast lesions with CE-MR multimodal morphological and kinetic analysis: comparison with conventional mammography and high-resolution ultrasound. Eur J Radiol, 2009, 70(1): 69-76.
35.	Yang W, Dempsey PJ. Diagnostic breast ultrasound: current status and future directions. Radiol Clin North Am, 2007, 45(5): 845-861.
36.	Taylor D, Lazberger J, Ives A, et al. Reducing delay in the diagnosis of pregnancy－associated breast cancer: how imaging can help us. J Med Imaging Radiat Oncol, 2011, 55(1): 33-42.

1. Mandelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval and screen-detected cancers. Journal of the National Cancer Institute, 2000, 92(13): 1081-1087.
2. Adler DD, Carson PL, Rubin JM, et al. Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings. Ultrasound in Medicine & Biology, 1990, 16(6): 553-559.
3. Anderson BO, Shyyan R, Eniu A, et al. Breast cancer in limited-resource countries: an overview of the breast health global initiative 2005 guidelines. Breast J, 2006, 12 (Suppl 1): 3-15.
4. Creager AJ, Madden CR, Bergman S, et al. Aneurysmal bonecyst: fine-needle aspriation findings in 23 patients with clinical and radiologic correlation. Am J Clin Pathol, 2007, 128(5): 740-745.
5. 李养敏, 杨梦玲, 千艳秋. 彩色多普勒超声对乳腺良恶性肿块的鉴别诊断价值. 实用医学影像杂志, 2008, 9(6): 390.
6. Schulz-Wendtland R,Beck K,Aichinger U, et al. Ultrasound examination of the breast with 7.5 MHz and 13 MHZ-transdcers: scope for improving diagnostic accuracy in complementary breast diagnostics? Ultraschall Med, 2005, 26(3): 209-215.
7. 刁骧, 艾昌林, 秦莉, 等译. QUADAS的制定: 用于系统评价诊断性研究质量的工具. 中国循证医学杂志, 2007, 7(4): 296-306.
8. 张天嵩, 钟文昭. Meta-DiSc软件在诊断试验Meta分析中的应用. 循证医学, 2008, 8(2): 97-100.
9. Habel LA, Capra AM, Oestreicher N, et al. Mammographic density in a multiethnic cohort. Menopause, 2007, 14(5): 891-899.
10. 王怀娥, 张宗欣, 尚延海, 等. 新型钼靶X线机与多普勒超声对乳腺结节的诊断价值. 医学影像学杂志, 2001,11(2): 89-93.
11. 张宏艳, 梁峰, 刘瑞祺. 临床查体、乳腺超声及X线检查诊断中国人乳腺癌的评价. 解放军医学杂志, 2007, 32(11): 1167-1170.
12. 赵红佳, 董宝玮, 许荣, 等. 超声造影定量分析在乳腺肿瘤诊断中的应用价值. 中华乳腺病杂志(电子版), 2008, 2(6): 634-640.
13. 蓝健君, 郭依廷, 周琼, 等. 钼靶X线、彩色多普勒超声对乳腺结节诊断的临床应用价值.中国中西医结合影像学杂志, 2008, 6(5): 358-360, 363.
14. 吴颖猛, 梁毅, 姜海明. 乳腺癌MRI与全数字化钼靶摄影及乳腺B超的对比研究. 中山大学学报, 2009, 30 (4S): 232-233.
15. 温悦. 超声、钼靶及MRI对乳腺疾病诊断的对比性分析. 河北医科大学, 2010.
16. 项洋锋. 磁共振、B超及钼靶对乳腺疾病的诊断价值. 浙江大学, 2010.
17. 徐煜佳, 曹霞. 乳腺肿块的三维超声诊断及其与钼靶X线的对比研究. 黑龙江医药科学, 2010, 33(5): 47-48.
18. 德杰, 李彩英, 冯平勇, 等. 数字钼靶X线摄影与彩色多普勒超声对乳腺肿块的诊断价值. 放射学实践, 2010, 25(1): 55-58.
19. 陈文清, 刘光洪, 郑进华, 等. 钼靶X线、高频彩超联合MRI在乳腺癌术前评估中的价值. 中国妇幼保健, 2010, 25(27): 3986-3987.
20. 夏晓天, 何萍青, 林燕苹, 等. 乳腺X线摄影、超声与MRI增强检查在乳腺疾病诊断中的比较. 外科理论与实践, 2010, 15(5): 473-476.
21. 丁勇俊, 何玉洁, 范晓芳, 等. ROC评价钼靶摄影、超声与磁共振增强在乳腺肿块良性诊断中的应用. 中国医学创新, 2009, 6(26): 149-151.
22. 夏长虹, 王莉, 陆建平, 等. 超声联合磁共振成像诊断乳腺癌与病理学对照研究. 中华医学超声杂志(电子版), 2011, 8(6): 1267-1271.
23. 赵丽. 钼靶、超声、钼靶和超声联合与MRI影像学在早期乳腺癌应用及价值探讨. 中国临床医学影像杂志, 2011, 22(10): 728-730.
24. 张秀梅, 李佳睿, 王刚, 等. 数字化钼靶、超声、MRI及MR扩散加权在老年乳腺肿瘤中的临床诊断价值. 中国老年病学杂志, 2011, 31(16): 3030-3032.
25. 尤厚成, 刘健, 尤楠, 等. 超声造影对乳腺良恶性肿块鉴别诊断的价值. 中国普外基础与临床杂志, 2011, 18(8): 861-865.
26. 鲍朝辉. 不同检查方法在乳腺癌诊断中的效果分析. 中外医学研究, 2011, 9(24): 60-61.
27. 张茂. 高频彩色多普勒超声诊断乳腺肿块的临床应用. 中外医疗, 2011, 11(5): 174-175.
28. 陈杰, 吴晓萍, 李旭霞, 等. 超声造影和彩色多普勒超声联合检查乳腺肿块的临床价值.医学影像学杂志, 2012, 22(2): 286-287.
29. 杨丽丽. 钼靶X线和彩色多普勒超声在乳腺肿块诊断中的应用. 新疆医科大学, 2012.
30. Malur S, Wurdinger S, Moritz A, et al. Comparison of written reports of mammography for preoperative evaluation of breast lesions, with special emphasis on magnetic resonance mammography. Breast Cancer, 2001, 3(5): 55-60.
31. Berg WA, Gutierrez L, NessAives MS, et al. Diagnostic accuracy of mammography, clinical examination, US and MR imaging in preoperative assessment of breast cancer. Radiology, 2004, 233(3): 830-849.
32. Ozulker T, Ozulker F, Ozpacaci T, et al. The efficacy of 99mTc-MIBI scintimammography in the evaluation of breast lesions and auxiliary involvement: a comparison with X-rays mammography ultrasonography and magnetic resonance imagine. Hell J Nucl Med, 2010, 13(2): 144-149.
33. Pediconi F, Catalano C, Roselli A, et al. The challenge of imagine dense breast parenchyma : magnetic resonance mammography the technique of choice? A comparative study with X-ray mammography and whole-breast ultrasound. Invest Radiol, 2009, 44(7): 412-421.
34. Vassiou K, Kanavou T, Vlychou M, et al. Characterization of breast lesions with CE-MR multimodal morphological and kinetic analysis: comparison with conventional mammography and high-resolution ultrasound. Eur J Radiol, 2009, 70(1): 69-76.
35. Yang W, Dempsey PJ. Diagnostic breast ultrasound: current status and future directions. Radiol Clin North Am, 2007, 45(5): 845-861.
36. Taylor D, Lazberger J, Ives A, et al. Reducing delay in the diagnosis of pregnancy－associated breast cancer: how imaging can help us. J Med Imaging Radiat Oncol, 2011, 55(1): 33-42.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of Color Doppler Ultrasonic for Female Breast Cancer: A Meta-Analysis

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