Diagnostic Challenges and new strategies in revealing malignant breast lesions with dense tissues

Introduction: Breast cancer is one of the most common invasive diseases and the second leading cause of death among women worldwide [۱, ۲]. Because with timely diagnosis, the effectiveness of treatment methods can be optimized, and the chances of survival can be increased [۳-۵]. This study evaluated the accuracy, specificity, and sensitivity of different medical imaging methods in breast cancer to clarify the most efficient breast cancer detection method using the meta-analysis method.Materials and methods: In total, ۸ articles published between ۲۰۰۳ and ۲۰۲۳ worldwide were selected by searching PubMed, Scopus, Embase, Web of Science, and Cochrane Library. Keywords such as breast cancer, neoplasm, medical imaging, mammography, MR mammography, ultrasound, molecular imaging, and their combinations were used in the search. Two radiotechnologists and one academic reviewed the articles to determine whether the studies met the inclusion criteria. The quality of the study was assessed using the diagnostic accuracy evaluation tool. Summary estimates of diagnostic sensitivity, specificity, and accuracy were obtained using ratios and diagnostic meta-analysis.Results: From ۸۴ studies that were screened for title, abstract, and full text, ۸ articles were included in quantitative and qualitative synthesis. Results were reported for sensitivity, specificity, positive and negative predictive value, and cancer detection rate in women with dense breasts undergoing complementary imaging. The studies included in this review were heterogeneous, as was the proportion of women experiencing the prevalence and incidence screening rounds. The sensitivity of mammography, ultrasound, MR mammography, and molecular imaging was ۵۹%, ۶۵%, ۹۴%, and ۹۸%, respectively. These results show that mammography requires mass formation or calcium deposition to show dense breast malignancy. The modality requires a mass with an average size of ۰.۹ cm to detect these breasts. On the other hand, MR imaging resulted in a ۴.۵% increase in cancer detection rate and found malignancy in ۱۲% with a PPV of ۳۹%. However, molecular imaging methods provide early detection without anatomical changes in the early stages of diagnosis.Conclusion: The present meta-analysis showed a positive and direct correlation between molecular imaging methods and detecting malignant breast cancer lesions with dense tissue. However, Molecular imaging can make timely diagnoses for effective treatment, follow-up staging, and planning for effective treatment.

کلیدواژه ها:

Medical imaging ، Molecular imaging ، Breast Cancer ، Sensitivity and Specificity