title: Screening Ultrasound in Women with Negative Mammography: Outcome Analysis.
abstract: OBJECTIVE
  To show the results of an audit of screening breast ultrasound (US) in women with negative mammography in a single institution and to analyze US-detected cancers within a year and interval cancers.
  
  
  METHODS
  During the year of 2006, 1974 women with negative mammography were screened with US in our screening center, and 1727 among them had pathologic results or any follow up breast examinations more than a year. We analyzed the distribution of Breast Imaging Reporting and Data System (BI-RADS) category and the performance outcome through follow up.
  
  
  RESULTS
  Among 1727 women (age, 30-76 years, median 49.5 years), 1349 women (78.1%) showed dense breasts on mammography, 762 (44.1%) had previous breast US, and 25 women (1.4%) had a personal history of breast cancers. Test negatives were 94.2% (1.627/1727) [BI-RADS category 1 in 885 (51.2%), 2 in 742 (43.0%)]. The recall rate (=BI-RADS category 3, 4, 5) was 5.8%. Eight cancers were additionally detected with US (yield, 4.6 per 1000). The sensitivity, specificity, and positive predictive value (PPV1, PPV2) were 88.9%, 94.6%, 8.0%, and 28.0%, respectively. Eight of nine true positive cancers were stage I or in-situ cancers. One interval cancer was stage I cancer from BI-RADS category 2.
  
  
  CONCLUSIONS
  Screening US detected 4.6 additional cancers among 1000. The recall rate was 5.8%, which is in lower bound of acceptable range of mammography (5-12%), according to American College of Radiology standard.
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. bkhan@skku.edu.
authors.forename: Boo-Kyung
authors.initials: BK
authors.lastname: Han
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Ko
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jung Hee
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Soo Yeon
authors.initials: SY
authors.lastname: Hahn
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Mee Young
authors.initials: MY
authors.lastname: Nam
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods; D016217:Ultrasonography, Mammary
keywords: Breast neoplasms, diagnosis; breast neoplasms, ultrasonography; cancer screening