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Reply to 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 1893–1894 (2021)Cite this article

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We thank Jayaraj et al. for their comments and appreciate this opportunity to clarify several issues of our study. Screening mammography (M) has a lower sensitivity in dense breasts compared to fatty ones.1,2,3 Breast ultrasonography (US), breast magnetic resonance imaging, 3D mammography and molecular breast imaging can identify occult cancers in dense breasts susceptible to multiple confounding factors.1,2,3 Unlike the other three tests, highly operator-dependent US includes many false positives in cancer results in dense breasts; requires additional imaging or a biopsy and has a lower positive predictive value and limited specificity.1,2,3 However, in addition to not requiring intravenous contrast administration, breast compression or ionising radiation, supplemental breast US is the most widely available and economical of the tests.2,4 Extensive experience with supplemental breast US, revised patient selective criteria and new diagnostic modes could improve the above-mentioned US disadvantages.1,4 How to achieve the best efficacy of supplemental breast cancer-screening US needs further exploration.

A meta-analysis has greater credibility if researchers can synthesise and analyse many relevant studies with substantial quantitative and qualitative follow-up data. After strictly selecting studies that met our specific inclusion criteria, we considered that including all studies, even those with relatively small sample sizes, were indispensable to preserving the integrity of the data. We explained in detail these “Limitations” in our article.

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References

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Acknowledgements

We thank Convergence CT, Taiwan to help statistical analysis.

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Authors and Affiliations

  1. Division of Radiology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan, ROC

    Wei-Hsin Yuan

  2. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC

    Wei-Hsin Yuan & Chia-Hung Wu

  3. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Wei-Hsin Yuan & Chia-Hung Wu

  4. Department of Medical Imaging, Taiwan Adventist Hospital, Taipei, Taiwan, ROC

    Hui-Chen Hsu

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  1. Wei-Hsin Yuan
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Contributions

W.H.Y. and H.C.H. participated in the conception, design and implementation of the study. W.H.Y. and H.C.H. participated in literature research. W.H.Y. wrote the paper. H.C.H. and C.H.W. revised the paper. W.H.Y. and H.C.H. guaranteed the integrity of the entire study, performed the statistical analysis and definition of intellectual content. All authors reviewed and approved the final paper.

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Correspondence to Wei-Hsin Yuan.

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Yuan, WH., Hsu, HC. & Wu, CH. Reply to Comment on “Supplemental breast cancer-screening ultrasonography in women with dense breasts: a systematic review and meta-analysis”. Br J Cancer 124, 1893–1894 (2021). https://doi.org/10.1038/s41416-021-01349-2

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  • DOI: https://doi.org/10.1038/s41416-021-01349-2

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