The value of substratified combined imaging assessment with mammography and ultrasonography for Chinese women with palpable breast masses

A 5-point breast imaging classification modified from the seven-category Breast Imaging-Reporting and Data System has been applied for mammographic and ultrasonographic examinations in patients with palpable breast masses. The aim of this study was to confirm the value of combined imaging assessment. We included 5,296 cases (3,002 benign and 2,294 cancer) from January 2004 to December 2011. Ultrasonography showed a significantly (P < 0.01) higher sensitivity and specificity and lower false-negative rate and false-negative predictive value (false-NPV) than mammography. The sensitivity of combined imaging was significantly (P < 0.01) increased and the false-negative rate and false-NPV were significantly (P < 0.01) reduced compared to mammography or ultrasonography alone. However, the specificity was significantly (P < 0.01) declined for combined imaging versus mammography or ultrasonography alone. Compared with combined imaging assessment, a significant (P < 0.01) improvement was noted with substratified scoring, with increased specificity and false-negative rate and decreased sensitivity. In conclusion, the substratified combined imaging score has the potential to provide additional value in the workup of palpable breast lesions.