Diagnostic performance of mammography and ultrasound in breast cancer: a systematic review and meta-analysis

Purpose The purpose of this study was to assess the diagnostic performance of mammography (MMG) and ultrasound (US) imaging for detecting breast cancer. Methods Comprehensive searches of PubMed, Scopus and EMBASE from 2008 to 2021 were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of MMG and US. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months were used as golden reference. Results Analysis of the studies revealed that the overall validity estimates of MMG and US in detecting breast cancer were as follows: pooled sensitivity per-patient were 0.82 (95% CI 0.76–0.87) and 0.83 (95% CI 0.71–0.91) respectively, The pooled specificities for detection of breast cancer using MMG, and US were 0.84 (95% CI 0.73–0.92) and 0.84 (95% CI 0.74–0.91) respectively. AUC of MMG, and US were 0.8933 and 0.8310 respectively. Pooled sensitivity and specificity per-lesion was 76% (95% CI 0.62–0.86) and 82% (95% CI 0.66–0.91) for MMG and 94% (95% CI 0.87–0.97) and 84% (95% CI 0.74–0.91) for US. Conclusions The meta-analysis found that, US and MMG has similar diagnostic performance in detecting breast cancer on per-patient basis after corrected threshold effect. However, on a per-lesion basis US was found to have a better diagnostic accuracy than MMG.