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Comment on “Supplemental breast cancer-screening ultrasonography in women with dense breasts: a systematic review and meta-analysis”

British Journal of Cancer volume 124, pages 1891–1892 (2021)Cite this article

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We commend Yuan et al. for having discussed the PRISMA approach ostentatiously. In accordance with the PRISMA guidelines, Yuan et al. have performed a thorough systematic review and meta-analysis examining the diagnostic performance of mammography alone plus Ultrasound (US) for breast cancer in women with dense breasts, as well as that of follow-up US in women with dense breasts and negative mammography results. We also commend the authors who have comprehensively collated data regarding recall rate, biopsy rate and biopsy-referenced positive predictive value (PPV) across multiple other studies.1 There are several critical points that may need to be elucidated so as to augment the validity of the authors’ multifactorial findings.

Digital mammograms save images of the breast that can be scrutinised for a detailed analysis and are more effective in tracing the dense breast tissue than the previous mammographic technique. Breast MRI, 3D mammogram, molecular breast imaging have their merits and limitations but unlike ultrasound imaging they are not operator dependent in interpreting the quality of images. The limited specificity of an Ultrasound warrants the need for an additional imaging or an invasive biopsy. The multiple confounding factors affect breast density, such as age, menopausal status, medications, pregnancy, and genetics eclipse the predictive value of imaging in detecting occult cancer.2,3

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References

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Authors and Affiliations

  1. Department of Artificial Intelligence, Nanjing University of Information Science and Technology (NUIST), Nanjing, Jiangsu, China

    Rama Jayaraj & Peter Shaw

  2. Northern Territory Institute of Research and Training, Darwin, Northern Territory, Australia

    Rama Jayaraj

  3. Fellow in Oral oncology, Manipal College of Dental Sciences, Mangalore, Karnataka, India

    Sameep Shetty

  4. School of Public Health, The University of Adelaide, North Terrace Campus, Adelaide, SA, Australia

    Chellan Kumaraswamy

  5. School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India

    K. M. Gothandam

  6. Department of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia

    M. Ravishankar Ram

  7. GenesisCare Gold Coast Radiation Oncologist, John Flynn Hospital, Tugun, QLD, Australia

    Siddhartha Baxi

Authors
  1. Rama Jayaraj
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  2. Peter Shaw
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  7. Siddhartha Baxi
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Contributions

R.J. predominantly conceived this review and led the development of the letter to the editor. R.J., P.S., S.S.S. and C.K. wrote the first draft of the letter, and G.K.M., R.R.M. and S.B. critically revised and edited successive drafts of the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Rama Jayaraj.

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Jayaraj, R., Shaw, P., Shetty, S. et al. Comment on “Supplemental breast cancer-screening ultrasonography in women with dense breasts: a systematic review and meta-analysis”. Br J Cancer 124, 1891–1892 (2021). https://doi.org/10.1038/s41416-021-01348-3

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