关键词: 乳腺癌, 筛查方法, 乳腺超声, BI-RADS 3类

Abstract: Objective To evaluate the implementation efficiency of the screening program, and to focus on the incremental diagnostic value of X-ray examination in people classified by ultrasound BI-RADS into 0 and 3 categories. Methods The data were collected from the Guangdong Women and Children Information Platform and finally included 683 765 women aged 35-64 who participated in the free breast cancer screening project in Guangdong Province in 2024 for analysis. Results There were significant differences in the distribution of basic characteristics among different age groups （P<0.001）. This study revealed no significant differences in histopathology biopsy rates across age groups. Overall, the biopsyrate was 67.97%, with a breast cancer detection rate of 120.66 per 100,000. In 2024, the detection rate of breast cancer in Guangdong Province increased with age （χ²=169.549, P<0.001）. Taking the results of histopathological examination as the gold standard, the sensitivity of ultrasound examination was the highest （79.88%）, the sensitivity of clinical examination and X-ray examination was low （20.36%, 22.06%）, and the specificity of the three methods was high （99.04%~99.94%）. In the ultrasound category 0/3 population, X-ray examination downgraded 50.23% to category 1/2, and upgraded 3.76% to category 4/5. The overall detection rate of extra cancer was 26.62 per 100 000. Conclusion Ultrasound examination, as the main method of breast cancer screening, has the core diagnostic value in screening, and its sensitivity is significantly higher than other screening methods. X-ray examination provides definite incremental value for the ultrasound category 0/3 population, which can not only avoid unnecessary biopsy, but also identify additional cancer cases.

Key words: breast cancer, screening methods, breast ultrasound, BI-RADS 3