Breast Cancer: Sensitivity and Specificity

Introduction: None written.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Nipple discharge	6%	6-12% of patients with unilateral nipple discharge have breast carcinoma
Screening Population	0.5%	J Natl Cancer Inst 2000 Jun 21;92(12):971-6. PMID 10861308
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The sensitivity and specificity of findings for Breast Cancer are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Mammography, Screening

86%

96%

Sensitivity and specificity of mammography vary widely from study to study

Study: Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study.

Banks E; Reeves G; Beral V; Bull D; Crossley B; Simmonds M; Hilton E; Bailey S; Barrett N; Briers P; English R; Jackson A; Kutt E; Lavelle J; Rockall L; Wallis MG; Wilson M; Patnick J

BMJ 2004 Aug 28;329(7464):477.

PMID 15331472

Diagnostic performance of digital versus film mammography for breast-cancer screening.

Pisano ED; Gatsonis C; Hendrick E; Yaffe M; Baum JK; Acharyya S; Conant EF; Fajardo LL; Bassett L; D'Orsi C; Jong R; Rebner M

N Engl J Med 2005 Oct 27;353(17):1773-83. Epub 2005 Sep 16.

PMID 16169887

Specific Findings

Clinical Breast Exam

58.8%

93.4%

in screening population by community practitioners

another similar study found spec = 99.4%

In the latter study, for diagnostic breast exams (i.e. for a complaint) specificity was only 68.7%.

Study: J Natl Cancer Inst 2000 Jun 21;92(12):971-6. PMID 10861308

J Gen Intern Med. 2007 Mar;22(3):332-7. PMID 17356964

MRI

79%

89%

Most studies have evaluated MRI in high risk populations.

Study: Table 1 of this paper has a summary of results from multiple studies comparing mammography to MRI for breast cancer detection in high risk patients

Breast MRI for cancer detection and characterization: a review of evidence-based clinical applications.

DeMartini W, Lehman C, Partridge S.

Acad Radiol. 2008 Apr;15(4):408-16.

PMID 18342764

Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition.

Kriege et al

N Engl J Med. 2004 Jul 29;351(5):427-37.

PMID: 15282350

http://content.nejm.org/cgi/content/abstract/351/5/427

Sensitive Findings

Core Needle Biopsy

Sensitivity = 98%

versus open surgical biopsy

sensitivities were quite similar between ultrasound-guided and stereotactic biopsy

Study: Bruening W, et al. "Systematic Review: Comparative Effectiveness of Core-Needle and Open Surgical Biopsy to Diagnose Breast Lesions". Ann Int Med.

http://www.annals.org/content/early/2009/12/08/0003-4819-152-1-201001050-00190.abstract

Findings With Unspecified Accuracy

Ultrasound

No accuracy specified.

Study: no study specified.

CA 15-3

No accuracy specified.

Study: no study specified.