The aim of this study was to assess the diagnostic performance of breast im
aging in the diagnosis of breast cancer in a non-screening population. In a
consecutive set of patients referred for mammography in one year, the resu
lts of palpation and radiological breast imaging were scored on a 5-point g
rading scale and linked to pathology as gold standard after a follow up per
iod of one year, The diagnostic performance was studied by logistic regress
ion analysis and ROC-curves. There were 1,944 breast examinations in 1,890
patients and 3,816 breasts. Pathology results reported 118 malignancies in
115 women. With a cut-off point between benign and uncertain benign a sensi
tivity of 89% and a specificity of 98% was found for radiological imaging.
ROC-curves showed a significant increase in diagnostic performance when rad
iology was added to results of palpation and age (p = 0.007). Radiological
imaging tests have a large diagnostic value in the detection of breast canc
er in addition to palpation and age. A sensitivity close to 100% could be r
eached. (C) 2001 Wiley-Liss, Inc.