Sensitivity and specificity of ultrasound and mammography for detection of breast malignancy: A systematic review and metaanalysis

Abstract

Author(s): Neda Azarpey*

Background and Aim: In recent years, breast cancer is the most common cancer among women, and the average age of its occurrence is decreasing. Due to dense breast tissue in younger women, which reduces the sensitivity of mammography in the diagnosis of carcinoma. The use of ultrasound as a supplement to mammography is very useful in its diagnosis. Thus, this systematic review and meta-analysis is aimed at pooling the sensitivity and specificity of mammography and ultrasonography in detection of breast malignancy. Methods: We performed a systematic search of literature in PubMed, Web of Science, and Scopus with relevant keywords. Studies that did not perform ultrasound or mammography or did not perform any comparison were excluded. Data extraction was performed based on a standardized sheet. Pooling the sensitivities and specificities was performed with STATA, R, and RStudio. Results: The initial search retrieved 19,022 articles from which 8753 duplicates were removed. Finally, 28 studies were included based on our eligibility criteria. The pooled sensitivity of mammography in detection of breast malignancy was 78% (95% CI: 72% - 83%, p-value < 0.001). The pooled specificity of mammography in detection of breast malignancy was 78% (95% CI: 66% - 86%, p-value < 0.001). The pooled sensitivity of ultrasonography in detection of breast malignancy was 87% (95% CI: 80% - 92%, p-value < 0.001). The pooled specificity of ultrasonography in detection of breast malignancy was 75% (95% CI: 61% - 84%, p-value < 0.001). Conclusion: According to the findings of our study, ultrasonography had higher sensitivity for detection breast lesion malignancy compared to mammography, however, mammography showed higher specificity for detection of breast malignancy.

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