Value of Three-Dimensional Ultrasound in Differentiating Malignant From Benign Breast Tumors: A Systematic Review and Meta-Analysis

Currently, the aim of differentiating malignant from benign breast tumors and diagnosing early breast cancer is more accurately fulfilled with the addition of ultrasound (US) scans. Some studies have shown that three-dimensional (3D) imaging opens a new diagnostic window because of a better and more detailed impression of the spatial arrangement of focal breast masses. Therefore, we carried out this study to assess the efficacy of 3D-US diagnostic techniques for the detection of breast cancer using systemic analyses. We searched the MEDLINE, Pubmed, EMBASE, and Cochrane Library for using 3D-US for the diagnosis of breast cancer. The terms used were three-dimensional ultrasound, breast neoplasms, sensitivity and specificity, and accuracy. Patients were adults. The quality of the studies was checked according to Quality Assessment of Diagnostic Accuracy Studies criteria. We calculated the diagnostic accuracy rates and developed a meta-analysis to synthesize the results. Twelve studies of diagnostic tests were selected, which were of moderate to high quality. The pooled sensitivity was 0.923 (95% confidence interval [CI], 0.896-0.945), and the pooled specificity was 0.872 (95% CI, 0.849-0.893). The meta-analysis detected a threshold effect and heterogeneity between studies. The pooled positive likelihood ratio was 6.965 (95% CI, 5.242-9.255), the negative likelihood ratio was 0.106 (95% CI, 0.079-0.142), and the diagnostic odds ratio was 84.239 (95% CI, 52.237-135.84). This meta-analysis indicates that 3D-US has acceptable diagnostic accuracy rates in differentiating malignant from benign breast tumors.