A Cross-Sectional Observational Study to Compare the Role of Ultrasound with Mammography in Women Identified at High Risk for Breast Cancer in a Population in China

Background: Currently, there is no national breast cancer screening program in China. In countries that have screening pro- grams, screening mammography is used. This study aimed to compare the imaging parameters and diagnostic findings between ultrasound and mammography in women at high risk who had a histologically confirmed diagnosis of breast cancer in a population in China. Material/Methods: A cross-sectional observational study included 1,687 women with a risk score of >= 30, according to the cancer risk assessment model, who underwent breast ultrasound and mammography. Women who had a Breast Imaging-Reporting and Data System (BI-RADS) score of 4 or 5 were identified, and 155 women had breast cancer confirmed by breast biopsy and histology. The ultrasound and mammography findings were evaluated and compared. Results: Breast ultrasound resulted in significantly fewer inconclusive results (BI-RADS score, 0), when compared with mammography (p=0.046). In cases with a histologically confirmed diagnosis of breast cancer (BI-RADS score, 4), the diagnostic sensitivity of breast ultrasound and mammography were 0.989 and 0.859, respectively. In cases with a histologically confirmed diagnosis of breast cancer (BI-RADS score, 5), the diagnostic sensitivity of breast ultrasound and mammography were 1.000 and 0.984, respectively. In cases with a histologically confirmed diagnosis of benign breast lesions (BI-RADS score, 2), there was no significant difference between breast ultrasound and mammography. Conclusions: In a population of women in China, breast ultrasound was a more sensitive diagnostic imaging method for women with high risk BI-RADS 4 and 5 breast lesions.