title: Role of computer-aided detection in very small screening detected invasive breast cancers.
abstract: This study aims to assess computer-aided detection (CAD) performance with full-field digital mammography (FFDM) in very small (equal to or less than 1 cm) invasive breast cancers. Sixty-eight invasive breast cancers less than or equal to 1 cm were retrospectively studied. All cases were detected with FFDM in women aged 49-69 years from our breast cancer screening program. Radiological characteristics of lesions following BI-RADS descriptors were recorded and compared with CAD sensitivity. Age, size, BI-RADS classification, breast density type, histological type of the neoplasm, and role of the CAD were also assessed. Per-study specificity and mass false-positive rate were determined by using 100 normal consecutive studies. Thirty-seven (54.4 %) masses, 17 (25 %) calcifications, 6 (8.8 %) masses with calcifications, 7 (10.3 %) architectural distortions, and 1 asymmetry (1.5 %) were found. CAD showed an overall sensitivity of 86.7 % (masses, 86.5 %; calcifications, 100 %; masses with calcifications, 100 %; and architectural distortion, 57.14 %), CAD failed to detect 9 out of 68 cases: 5 of 37 masses, 3 of 7 architectural distortions, and 1 of 1 asymmetry. Fifteen out of 37 masses were hyperdense, and all of them were detected by CAD. No association was seen among mass morphology or margins and detectability. Per-study specificity and CAD false-positive rate was 26 % and 1.76 false marks per study. In conclusion, CAD shows a high sensitivity and a low specificity. Lesion size, histology, and breast density do not influence sensitivity. Mammographic features, mass density, and thickness of the spicules in architectural distortions do influence.
authors.affiliation: Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel,170, 08036, Barcelona, Spain. xbarga@clinic.ub.es
authors.forename: Xavier
authors.initials: X
authors.lastname: Bargalló
authors.forename: Martín
authors.initials: M
authors.lastname: Velasco
authors.forename: Gorane
authors.initials: G
authors.lastname: Santamaría
authors.forename: Montse
authors.initials: M
authors.lastname: Del Amo
authors.forename: Pedro
authors.initials: P
authors.lastname: Arguis
authors.forename: Sonia
authors.initials: S
authors.lastname: Sánchez Gómez
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity