Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.

To evaluate the diagnostic impact of point-of-care breast ultrasound by trained primary care physicians (PCPs) as part of a breast cancer detection program using clinical breast exam in an underserved region of Peru. Medical records and breast ultrasound images of symptomatic women presenting to the...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Segen Aklilu, Carolyn Bain, Pooja Bansil, Silvia de Sanjose, Jorge A Dunstan, Vanesa Castillo, Vivien Tsu, Ines Contreras, Ronald Balassanian, Tara K Hayes Constant, John R Scheel
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bfe5d63b5efd48fdb37282eb7a124870
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:bfe5d63b5efd48fdb37282eb7a124870
record_format	dspace
spelling	oai:doaj.org-article:bfe5d63b5efd48fdb37282eb7a1248702021-12-02T20:10:46ZEvaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.1932-620310.1371/journal.pone.0252902https://doaj.org/article/bfe5d63b5efd48fdb37282eb7a1248702021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252902https://doaj.org/toc/1932-6203To evaluate the diagnostic impact of point-of-care breast ultrasound by trained primary care physicians (PCPs) as part of a breast cancer detection program using clinical breast exam in an underserved region of Peru. Medical records and breast ultrasound images of symptomatic women presenting to the Breast Cancer Detection Model (BCDM) in Trujillo, Peru were collected from 2017-2018. Performance was measured against final outcomes derived from regional cancer center medical records, fine needle aspiration results, patient follow-up (sensitivity, specificity, positive, and negative predictive values), and by percent agreement with the retrospective, blinded interpretation of images by a fellowship-trained breast radiologist, and a Peruvian breast surgeon. The diagnostic impact of ultrasound, compared to clinical breast exam (CBE), was calculated for actual practice and for potential impact of two alternative reporting systems. Of the 171 women presenting for breast ultrasound, 23 had breast cancer (13.5%). Breast ultrasound used as a triage test (current practice) detected all cancer cases (including four cancers missed on confirmatory CBE). PCPs showed strong agreement with radiologist and surgeon readings regarding the final management of masses (85.4% and 80.4%, respectively). While the triage system yielded a similar number of biopsies as CBE alone, using the condensed and full BI-RADS systems would have reduced biopsies by 60% while identifying 87% of cancers immediately and deferring 13% to six-month follow-up. Point-of-care ultrasound performed by trained PCPs improves diagnostic accuracy for managing symptomatic women over CBE alone and enhances access. Greater use of BI-RADS to guide management would reduce the diagnostic burden substantially.Segen AkliluCarolyn BainPooja BansilSilvia de SanjoseJorge A DunstanVanesa CastilloVivien TsuInes ContrerasRonald BalassanianTara K Hayes ConstantJohn R ScheelPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252902 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Segen Aklilu Carolyn Bain Pooja Bansil Silvia de Sanjose Jorge A Dunstan Vanesa Castillo Vivien Tsu Ines Contreras Ronald Balassanian Tara K Hayes Constant John R Scheel Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.
description	To evaluate the diagnostic impact of point-of-care breast ultrasound by trained primary care physicians (PCPs) as part of a breast cancer detection program using clinical breast exam in an underserved region of Peru. Medical records and breast ultrasound images of symptomatic women presenting to the Breast Cancer Detection Model (BCDM) in Trujillo, Peru were collected from 2017-2018. Performance was measured against final outcomes derived from regional cancer center medical records, fine needle aspiration results, patient follow-up (sensitivity, specificity, positive, and negative predictive values), and by percent agreement with the retrospective, blinded interpretation of images by a fellowship-trained breast radiologist, and a Peruvian breast surgeon. The diagnostic impact of ultrasound, compared to clinical breast exam (CBE), was calculated for actual practice and for potential impact of two alternative reporting systems. Of the 171 women presenting for breast ultrasound, 23 had breast cancer (13.5%). Breast ultrasound used as a triage test (current practice) detected all cancer cases (including four cancers missed on confirmatory CBE). PCPs showed strong agreement with radiologist and surgeon readings regarding the final management of masses (85.4% and 80.4%, respectively). While the triage system yielded a similar number of biopsies as CBE alone, using the condensed and full BI-RADS systems would have reduced biopsies by 60% while identifying 87% of cancers immediately and deferring 13% to six-month follow-up. Point-of-care ultrasound performed by trained PCPs improves diagnostic accuracy for managing symptomatic women over CBE alone and enhances access. Greater use of BI-RADS to guide management would reduce the diagnostic burden substantially.
format	article
author	Segen Aklilu Carolyn Bain Pooja Bansil Silvia de Sanjose Jorge A Dunstan Vanesa Castillo Vivien Tsu Ines Contreras Ronald Balassanian Tara K Hayes Constant John R Scheel
author_facet	Segen Aklilu Carolyn Bain Pooja Bansil Silvia de Sanjose Jorge A Dunstan Vanesa Castillo Vivien Tsu Ines Contreras Ronald Balassanian Tara K Hayes Constant John R Scheel
author_sort	Segen Aklilu
title	Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.
title_short	Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.
title_full	Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.
title_fullStr	Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.
title_full_unstemmed	Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.
title_sort	evaluation of diagnostic ultrasound use in a breast cancer detection strategy in northern peru.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/bfe5d63b5efd48fdb37282eb7a124870
work_keys_str_mv	AT segenaklilu evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT carolynbain evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT poojabansil evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT silviadesanjose evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT jorgeadunstan evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT vanesacastillo evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT vivientsu evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT inescontreras evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT ronaldbalassanian evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT tarakhayesconstant evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu AT johnrscheel evaluationofdiagnosticultrasounduseinabreastcancerdetectionstrategyinnorthernperu
_version_	1718374970246037504

Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.

Ejemplares similares