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Review
. 2025 Mar 15;17(3):1554-1567.
doi: 10.62347/BMWY7899. eCollection 2025.

Meta-analysis of the synergistic effect of magnetic resonance imaging and mammography in breast cancer detection in women with dense breasts

Yu-Fei Lian  1 , Dan-Qing Liu  1 , Hui Wang  2
Affiliations
Review

Meta-analysis of the synergistic effect of magnetic resonance imaging and mammography in breast cancer detection in women with dense breasts

Yu-Fei Lian et al. Am J Transl Res. .

Abstract

Objectives: This meta-analysis aimed to evaluate the combined effectiveness of Magnetic Resonance Imaging (MRI) and mammography in detecting breast cancer in women with dense breasts.

Methods: A comprehensive search was conducted across PubMed, Web of Science, and EMBASE databases up to December 31, 2023, to identify relevant studies. Studies focusing on breast cancer detection in women with dense breast tissue and providing data on the sensitivity, specificity, or positive predictive value of combined MRI and mammography screening, or the use of MRI following a negative mammogram, were included. The meta-analysis was conducted using Stata 15.0, and study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.

Results: Ten studies, involving 51,602 participants, were included in the meta-analysis. The combined use of MRI and mammography for breast cancer detection in women with dense breasts yielded a pooled sensitivity of 0.87 (95% CI: 0.79-0.92), specificity of 0.95 (95% CI: 0.89-0.97), positive likelihood ratio of 2.55 (95% CI: 1.45-4.46), negative likelihood ratio of 0.11 (95% CI: 0.07-0.17), diagnostic score of 3.18 (95% CI: 2.35-4.02), and diagnostic ratio of 24.14 (95% CI: 10.44-55.81), and an area under the Summary Receiver Operating Characteristic curve of 0.97 (95% CI: 0.95-0.98).

Conclusion: This meta-analysis demonstrated that the combination of MRI and mammography enhanced breast cancer detection in women with dense breasts. This synergistic approach significantly improves detection sensitivity in this high-risk group.

Keywords: Breast cancer; Magnetic Resonance Imaging (MRI); dense breast tissue; mammography; meta-analysis.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Selection flow chart for identifying studies eligible for inclusion in the meta-analysis.
Figure 2
Figure 2
Forest plots of pooled sensitivity of synergistic effect of magnetic resonance imaging and mammography in the detection of breast cancer in women with dense breasts.
Figure 3
Figure 3
Forest plots of pooled specificity of synergistic effect of magnetic resonance imaging and mammography in the detection of breast cancer in women with dense breasts.
Figure 4
Figure 4
Forest plots of pooled positive likelihood ratio of synergistic effect of magnetic resonance imaging and mammography in the detection of breast cancer in women with dense breasts.
Figure 5
Figure 5
Forest plots of pooled negative likelihood ratio of synergistic effect of magnetic resonance imaging and mammography in the detection of breast cancer in women with dense breasts.
Figure 6
Figure 6
Forest plots of diagnostic score of synergistic effect of magnetic resonance imaging and mammography in the detection of breast cancer in women with dense breasts.
Figure 7
Figure 7
Summary receiver operating characteristic curve of the accuracy of synergistic effect of magnetic resonance imaging and mammography in the detection of breast cancer in women with dense breasts.
Figure 8
Figure 8
Deek’s funnel plot of the accuracy of synergistic effect of magnetic resonance imaging and mammography in the detection of breast cancer in women with dense breasts.
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