title: Verification of recall criteria for masses detected on ultrasound breast cancer screening.
abstract: OBJECTIVE
  Mammography is the only modality for breast cancer screening demonstrated to reduce the mortality rate. However, ultrasonographic screening is already being widely performed as opportunistic screening in Japan. The recall criteria for masses are very important as quality controls. The purpose of this study was to verify these criteria at multiple institutions.
  
  
  METHODS
  Screening was performed by five institutions in various regions in Japan. The total number of cases screened at all five institutions was 10,519.
  
  
  RESULTS
  The findings that could be concluded to be benign were a cystic pattern and three features of a solid pattern. The cystic pattern was noted in 6512 cases, typical fibroadenoma in 1483 cases, and typical complicated cyst in 70 cases. Only three of these 8065 cases were cancers, so the negative predictive value was 99.9%. The solid pattern with obvious malignant features, i.e., masses with an echogenic halo and/or interruption of the interface and masses with multiple echogenic foci, were noted in 33 cases. Twenty of the 33 cases were malignancy, resulting in a positive predictive value of 66.7%.
  
  
  CONCLUSIONS
  Although some parts of the criteria should be considered further for verification and revision, the current recall criteria are mostly valid.
authors.affiliation: Tokyo Health Service Association, Tokyo, Japan. k.ban@yobouigaku-tokyo.jp.|Research Group for Breast Cancer Screening of the Japan Association of Breast and Thyroid Sonology, Tokyo, Japan. k.ban@yobouigaku-tokyo.jp.
authors.forename: Kanako
authors.identifier: http://orcid.org/0000-0002-7244-2436
authors.initials: K
authors.lastname: Ban
authors.affiliation: Research Group for Breast Cancer Screening of the Japan Association of Breast and Thyroid Sonology, Tokyo, Japan.|St Luke's International Hospital, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tsunoda
authors.affiliation: St Luke's International Hospital, Tokyo, Japan.
authors.forename: Sakiko
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Wellness Tenjin Clinic, Fukuoka, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Takaki
authors.affiliation: Iwate Health Service Association, Morioka, Japan.
authors.forename: Kyouko
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Okayama Health Foundation, Okayama, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer / Q000592:standards; D005260:Female; D006801:Humans; D007564:Japan; D008403:Mass Screening / Q000592:standards*; D018579:Patient Selection; D011786:Quality Control; D016217:Ultrasonography, Mammary / Q000592:standards*
keywords: Breast cancer screening; Breast ultrasound; Recall criteria; Ultrasonographic screening