Diagnostic Accuracy of Breast Medical Tactile Examiners (MTEs): A Prospective Pilot Study.
Breast cancer
Clinical breast examination
Early cancer detection
Medical tactile examiners
Screening
Journal
Breast care (Basel, Switzerland)
ISSN: 1661-3791
Titre abrégé: Breast Care (Basel)
Pays: Switzerland
ID NLM: 101254060
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
entrez:
26
4
2019
pubmed:
26
4
2019
medline:
26
4
2019
Statut:
ppublish
Résumé
The usefulness of clinical breast examination (CBE) in general and in breast cancer screening programs has been a matter of debate. This study investigated whether adding vision-impaired medical tactile examiners (MTEs) improves the predictiveness of CBE for suspicious lesions and analyzed the feasibility and acceptability of this approach. The prospective study included 104 patients. Physicians and MTEs performed CBEs, and mammography and ultrasound results were used as the gold standard. Sensitivity and specificity were calculated and logistic regression models were used to compare the predictive value of CBE by physicians alone, MTEs alone, and physicians and MTEs combined. For CBEs by physicians alone, MTEs alone, and both combined, sensitivity was 71, 82, and 89% and specificity was 55, 45, and 35%, respectively. Using adjusted logistic regression models, the validated areas under the curve were 0.685, 0.692, and 0.710 (median bootstrapped p value (DeLong) = 0.381). The predictive value for a suspicious breast lesion in CBEs performed by MTEs in patients without prior surgery was similar to that of physician-conducted CBEs. Including MTEs in the CBE procedure in breast units thus appears feasible and could be a way of utilizing their skills.
Sections du résumé
BACKGROUND
BACKGROUND
The usefulness of clinical breast examination (CBE) in general and in breast cancer screening programs has been a matter of debate. This study investigated whether adding vision-impaired medical tactile examiners (MTEs) improves the predictiveness of CBE for suspicious lesions and analyzed the feasibility and acceptability of this approach.
METHODS
METHODS
The prospective study included 104 patients. Physicians and MTEs performed CBEs, and mammography and ultrasound results were used as the gold standard. Sensitivity and specificity were calculated and logistic regression models were used to compare the predictive value of CBE by physicians alone, MTEs alone, and physicians and MTEs combined.
RESULTS
RESULTS
For CBEs by physicians alone, MTEs alone, and both combined, sensitivity was 71, 82, and 89% and specificity was 55, 45, and 35%, respectively. Using adjusted logistic regression models, the validated areas under the curve were 0.685, 0.692, and 0.710 (median bootstrapped p value (DeLong) = 0.381).
CONCLUSION
CONCLUSIONS
The predictive value for a suspicious breast lesion in CBEs performed by MTEs in patients without prior surgery was similar to that of physician-conducted CBEs. Including MTEs in the CBE procedure in breast units thus appears feasible and could be a way of utilizing their skills.
Identifiants
pubmed: 31019442
doi: 10.1159/000495883
pii: brc-0014-0041
pmc: PMC6465747
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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