ObjectiveTo explore the classification of ultrasound breast imaging reporting and data system (BI-RADS) classification combined with serum trefoil factor 1 (TFF1) and human growth differentiation factor 3 (GDF3) in the differential diagnosis of benign and malignant breast masses. MethodsThe prospective study collected 113 female patients with breast masses who got treatment in Tangshan People’s Hospital from September 2020 to September 2023. Ultrasound diagnostic equipment was applied for ultrasound BI-RADS classification, ELISA method was applied to detect serum TFF1 and GDF3 levels, Consistency Kappa test was used to compare the consistency of ultrasound BI-RADS classification, serum TFF1 and GDF3 alone and combined in the diagnosis of benign and malignant breast masses and pathological results, In addition, receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the above indicators in the diagnosis of benign and malignant breast masses. ResultsAmong the 113 patients with breast mass, the pathological diagnosis showed benign mass in 48 cases and malignant mass in 65 cases. The serum levels of TFF1 [(1.62±0.25) μg/L vs (1.24±0.27) μg/L] and GDF3 [(118.62±21.73) ng/L vs (96.47±16.05) ng/L] in malignant patients were obviously higher than those in benign patients (P<0.001). There were 70 cases of malignant breast masses and 43 cases of benign breast masses according ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3. The diagnosis consistency with pathological results was very high and Kappa value was 0.835 (P<0.001). The sensitivity and specificity of ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3 in differential diagnosis of benign and malignant breast masses were 96.92% (63/65), 85.42% (41/48), respectively, the negative predictive value was 95.35% (41/43), and positive predictive value was 90.00% (63/70). The sensitivity, negative predictive value and accuracy were higher than those of ultrasonic BI-RADS classification and serum GDF3 alone (P<0.05), and the missed diagnosis rate was lower than that of ultrasonic BI-RADS classification and serum GDF3 alone (P<0.05). ConclusionsThe serum levels of TFF1 and GDF3 increase in patients with malignant breast masses. The combination of ultrasound BI-RADS classification and serum TFF1 and GDF3 can improve the sensitivity and accuracy of the diagnosis of benign and malignant breast masses, and reduce the missed diagnosis rate.
Objective To analyze the clinical value of elastography combined with automatic breast full volume imaging in distinguishing benign and malignant breast nodules of breast imaging reporting and data system (BI-RADS) category 4. MethodsThis retrospective study included patients with breast nodules of BI-RADS category 4 who confirmed by routine ultrasound in Zhengzhou Third People’s Hospital from January 2018 to December 2023. To compare the clinical efficacy of conventional conventional color doppler ultrasound (CDUS), coronal automated breast volume scanner (ABVS), ultrasound elastography (UE), coronal automatic breast volume imaging combined with UE in differential diagnosis of benign and malignant breast nodules of BI-RADS category 4. ResultsA total of 280 cases with 301 lesions were enrolled in this study, among which 195 lesions were pathologically diagnosed as benign and 106 as malignant. The Kappa values for the consistency between the diagnostic results of benign and malignant breast nodules of BI-RADS category 4 by CDUS, ABVS, UE, and the combination of coronal ABVS and UE with the pathological results were 0.702, 0.625, 0.717 and 0.978, respectively. The sensitivity of coronal ABVS combined with UE was 99.06% (105/106), the specificity was 98.97% (193/195), and the accuracy was 99.00% (298/301); The sensitivity of CDUS was 76.42% (81/106), the specificity was 92.31% (180/195), and the accuracy was 86.71% (261/301); the sensitivity of UE was 88.68% (94/106), the specificity was 77.95% (152/195), and the accuracy was 81.73% (246/301); the sensitivity of coronal ABVS was 87.74% (93/106), the specificity was 86.71% (168/195), and the accuracy was 86.71% (261/301). Receiver operating characteristic curve analysis showed that the area under the curve of the combination of coronal ABVS and UE was 0.990, which had superior diagnostic efficacy than CDUS (Z=–6.572, P<0.001), UE (Z=–7.525, P<0.001) and coronal ABVS (Z=–6.167, P<0.001). ConclusionThe combination of coronal ABVS and UE can effectively improve the differential diagnosis of benign and malignant breast nodules of BI-RADS category 4 and reduce the risk of clinical overdiagnosis.