What is the accuracy of breast imaging modalities for the diagnosis of breast cancer?

Updated: Dec 27, 2019
  • Author: Pavani Chalasani, MD, MPH; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

The different techniques used in breast imaging vary with respect to sensitivity, specificity, and positive predictive value (see Table 1 below).

Table 1. Accuracy of Breast Imaging Modalities (Open Table in a new window)

Modality

Sensitivity

Specificity

PPV

Indications

Mammography

63-95% (>95% palpable, 50% impalpable, 83-92% in women older than 50 y; decreases to 35% in dense breasts)

14-90% (90% palpable)

10-50%

(94% palpable)

Initial investigation for symptomatic breast in women older than 35 y and for screening; investigation of choice for microcalcification

Ultrasonography

68-97% palpable

74-94% palpable

92% (palpable)

Initial investigation for palpable lesions in women younger than 35 y

MRI

86-100%

21-97% (< 40% primary cancer)

52%

Scarred breast, implants, multifocal lesions, and borderline lesions for breast conservation; may be useful in screening high-risk women

Scintigraphy

76-95% palpable, 52-91% impalpable

62-94% (94% impalpable)

70-83% (83% palpable, 79% impalpable)

Lesions >1 cm and axilla assessment; may help predict drug resistance

PET

96% (90% axillary metastases)

100%

 

Axilla assessment, scarred breast, and multifocal lesions

MRI = magnetic resonance imaging; PET = positron emission tomography; PPV = positive predictive value.


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