Preliminary study on feasibility of breast masses screening by homemade domestic breast palpation imaging instead of clinical breast palpation examination_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

QU Fan ¹ , HE Xiaoliang ¹ , LAI Yuzhou ² , REN Lei ² , ZHANG Jing ¹ ,  TIAN Chao ^1,2

1. Department of Breast Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646099, P. R. China;
2. Sichuan Cancer Hospital & Institution, Department of Breast Surgery / Department of Breast Surgery, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu 610042, P. R. China;

Corresponding author：

TIAN Chao, Email: petrichor8293@163.com

Keywords：

breast palpation imaging; clinical breast examination; breast ultrasound; breast mass

DOI：

10.7507/1007-9424.202301025

Video：

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Objective To explore the feasibility of homemade domestic breast palpation imaging (BPI) instead of clinical breast palpation examination (CBE) for screening breast masses. Methods The patients who received breast ultrasonography (BUS), BPI examinations and CBE in the Sichuan Cancer Hospital from March 2022 to September 2022 were retrospectively collected. The result of BUS examination was used as the criteria to compare the efficiency and difference between the BPI examination and CBE in detecting breast masses. The effects of the patients’ body mass index, breast volume, tumor location, benign and malignant tumor, and maximum tumor diameter on the accuracy of breast tumor detection by BPI system were further analyzed. Results A total of 102 patients were included in this study. Among the 90 patients with breast mass detected by BUS, 76 cases were detected by BPI and 51 cases were detected by CBE. In the 12 patients without tumor mass detected by BUS, only 11 cases patients without tumor mass were detected by BPI and CBE. The sensitivity and accuracy of breast tumor mass screening by the BPI were higher than those by the CBE (84.4% vs. 56.7%, 85.2% vs. 60.7%, respectively), and the specificity was similar (91.6%, both). The area under the receiver operating characteristic curve (95% confidence interval, 95%CI) of BPI and CBE for screening breast masses were 0.903 (0.791, 0.970) and 0.799 (0.747, 0.851), respectively. The former was higher than the latter (Z=2.494, P=0.013). The consistencies were moderate (Kappa=0.518, P<0.001), general (Kappa=0.204, P=0.002), moderate (Kappa=0.518, P<0.001) between the BPI and BUS, between CBE and BUS, and between BPI and CBE for screening breast masses, respectively. The results of multivariate analysis of binary logistics regression indicated that the benign tumor mass was not easily detected [OR (95%CI） was 9.600（1.328, 69.400), P=0.025] and the tumor mass with breast volume ＜350 mL was easily detected [OR (95%CI） was 0.157 (0.030, 0.818), P=0.028], the diameter of tumor mass had no obvious influence on breast tumor mass screening by the BPI. Conclusion According to the preliminary results of this study, BPI can improve the sensitivity of detecting breast masses and make up for the lack of objective records of CBE, but BPI cannot replace CBE at present.

Citation： QU Fan, HE Xiaoliang, LAI Yuzhou, REN Lei, ZHANG Jing, TIAN Chao. Preliminary study on feasibility of breast masses screening by homemade domestic breast palpation imaging instead of clinical breast palpation examination. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(6): 686-690. doi: 10.7507/1007-9424.202301025 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Committee on Practice Bulletins—Gynecology. Practice bulletin number 179: breast cancer risk assessment and screening in average-risk women. Obstet Gynecol, 2017, 130(1): e1-e16. doi: 10.1097/AOG.0000000000002158.
3.	中国研究型医院学会乳腺专业委员会中国女性乳腺癌筛查指南制定专家组. 中国女性乳腺癌筛查指南(2022年版). 中国研究型医院, 2022, 9(2): 6-13.
4.	周星彤, 沈松杰, 孙强. 中国乳腺癌筛查现状及进展. 中国医学前沿杂志(电子版), 2020, 12(3): 6-11.
5.	Malmartel A, Tron A, Caulliez S. Accuracy of clinical breast examination’s abnormalities for breast cancer screening: cross-sectional study. Eur J Obstet Gynecol Reprod Biol, 2019, 237: 1-6.
6.	Kiely BE, Goodwin A. Is it time to abandon clinical breast examination? Med J Aust, 2021, 215(10): 458-459.
7.	Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics, 1977, 33(1): 159-174.
8.	乔群, 凌诒淳, 周刚, 等. 中国125名青年女性乳房体积测量. 中华整形烧伤外科杂志, 1991, 7(1): 1-3.
9.	沈松杰, 孙强. 制定中国女性乳腺癌筛查指南的意义. 中国研究型医院, 2022, 9(2): 23-27.
10.	瞿亚军, 吕青. 我国乳腺癌预防若干问题的思考. 中国普外基础与临床杂志, 2020, 27(11): 1334-1339.
11.	Romanoff A, Constant TH, Johnson KM, et al. Association of previous clinical breast examination with reduced delays and earlier-stage breast cancer diagnosis among women in Peru. JAMA Oncol, 2017, 3(11): 1563-1567.
12.	Mittra I, Mishra GA, Dikshit RP, et al. Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai. BMJ, 2021, 372: n256. doi: 10.1136/bmj.n256.
13.	von Euler-Chelpin M, Lillholm M, Vejborg I, et al. Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark. Breast Cancer Res, 2019, 21(1): 111. doi: 10.1186/s13058-019-1203-3.
14.	陈颖. 中国黑龙江地区乳腺密度及乳腺癌易感基因SNP的研究. 沈阳: 中国医科大学, 2011.
15.	唐艳艳. 基于成本-效果评价的我国农村妇女乳腺癌筛查策略优化研究. 武汉: 华中科技大学, 2019.
16.	李毅, 吕艳丽, 赵越等. 超声和X线检查对乳腺病变的诊断效能分析. 中华乳腺病杂志(电子版), 2016, 10(05): 295-299.
17.	Shen S, Zhou Y, Xu Y, et al. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women. Br J Cancer, 2015, 112(6): 998-1004.
18.	孙鑫, 韩优莉, 王乐, 等. 超声检查用于亚洲女性乳腺癌筛查卫生经济学研究的系统评价. 中国肿瘤, 2018, 27(7): 553-560.
19.	刘慧杰, 刘迪. 超声乳腺影像报告和数据系统分级在筛查社区女性乳腺癌中的应用. 当代医学, 2022, 28(11): 152-154.
20.	顾玉芳, 李国远. 乳腺触诊成像系统在乳腺疾病早期筛查中的应用分析. 中国初级卫生保健, 2022, 36(4): 77-79.
21.	Kaufman CS, Jacobson L, Bachman BA, et al. Digital documen-tation of the physical examination: moving the clinical breast exam to the electronic medical record. Am J Surg, 2006, 192(4): 444-449.
22.	Tasoulis MK, Zacharioudakis KE, Dimopoulos NG, et al. Diagnostic accuracy of tactile imaging in selecting patients with palpable breast abnormalities: a prospective comparative study. Breast Cancer Res Treat, 2014, 147(3): 589-598.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Committee on Practice Bulletins—Gynecology. Practice bulletin number 179: breast cancer risk assessment and screening in average-risk women. Obstet Gynecol, 2017, 130(1): e1-e16. doi: 10.1097/AOG.0000000000002158.
3. 中国研究型医院学会乳腺专业委员会中国女性乳腺癌筛查指南制定专家组. 中国女性乳腺癌筛查指南(2022年版). 中国研究型医院, 2022, 9(2): 6-13.
4. 周星彤, 沈松杰, 孙强. 中国乳腺癌筛查现状及进展. 中国医学前沿杂志(电子版), 2020, 12(3): 6-11.
5. Malmartel A, Tron A, Caulliez S. Accuracy of clinical breast examination’s abnormalities for breast cancer screening: cross-sectional study. Eur J Obstet Gynecol Reprod Biol, 2019, 237: 1-6.
6. Kiely BE, Goodwin A. Is it time to abandon clinical breast examination? Med J Aust, 2021, 215(10): 458-459.
7. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics, 1977, 33(1): 159-174.
8. 乔群, 凌诒淳, 周刚, 等. 中国125名青年女性乳房体积测量. 中华整形烧伤外科杂志, 1991, 7(1): 1-3.
9. 沈松杰, 孙强. 制定中国女性乳腺癌筛查指南的意义. 中国研究型医院, 2022, 9(2): 23-27.
10. 瞿亚军, 吕青. 我国乳腺癌预防若干问题的思考. 中国普外基础与临床杂志, 2020, 27(11): 1334-1339.
11. Romanoff A, Constant TH, Johnson KM, et al. Association of previous clinical breast examination with reduced delays and earlier-stage breast cancer diagnosis among women in Peru. JAMA Oncol, 2017, 3(11): 1563-1567.
12. Mittra I, Mishra GA, Dikshit RP, et al. Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai. BMJ, 2021, 372: n256. doi: 10.1136/bmj.n256.
13. von Euler-Chelpin M, Lillholm M, Vejborg I, et al. Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark. Breast Cancer Res, 2019, 21(1): 111. doi: 10.1186/s13058-019-1203-3.
14. 陈颖. 中国黑龙江地区乳腺密度及乳腺癌易感基因SNP的研究. 沈阳: 中国医科大学, 2011.
15. 唐艳艳. 基于成本-效果评价的我国农村妇女乳腺癌筛查策略优化研究. 武汉: 华中科技大学, 2019.
16. 李毅, 吕艳丽, 赵越等. 超声和X线检查对乳腺病变的诊断效能分析. 中华乳腺病杂志(电子版), 2016, 10(05): 295-299.
17. Shen S, Zhou Y, Xu Y, et al. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women. Br J Cancer, 2015, 112(6): 998-1004.
18. 孙鑫, 韩优莉, 王乐, 等. 超声检查用于亚洲女性乳腺癌筛查卫生经济学研究的系统评价. 中国肿瘤, 2018, 27(7): 553-560.
19. 刘慧杰, 刘迪. 超声乳腺影像报告和数据系统分级在筛查社区女性乳腺癌中的应用. 当代医学, 2022, 28(11): 152-154.
20. 顾玉芳, 李国远. 乳腺触诊成像系统在乳腺疾病早期筛查中的应用分析. 中国初级卫生保健, 2022, 36(4): 77-79.
21. Kaufman CS, Jacobson L, Bachman BA, et al. Digital documen-tation of the physical examination: moving the clinical breast exam to the electronic medical record. Am J Surg, 2006, 192(4): 444-449.
22. Tasoulis MK, Zacharioudakis KE, Dimopoulos NG, et al. Diagnostic accuracy of tactile imaging in selecting patients with palpable breast abnormalities: a prospective comparative study. Breast Cancer Res Treat, 2014, 147(3): 589-598.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Preliminary study on feasibility of breast masses screening by homemade domestic breast palpation imaging instead of clinical breast palpation examination

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