Latar belakang: Kanker payudara merupakan kanker dengan insiden tertinggi dan penyebab kematian utama akibat kanker pada perempuan di dunia. Penggunaan implan payudara pasca mastektomi maupun tujuan kosmetik juga ikut meningkat. Ultrasonografi, mamografi dan MRI adalah modalitas pencitraan utama dalam mendeteksi lesi kanker payudara pada pengguna implan payudara. Peranan USG dalam hal tersebut masih kontroversi; sensitivitas mamografi dilaporkan menurun sementara MRI terbatas penggunaanya akibat kendala ketersediaan dan biaya pemeriksaan tinggi. Telaah sistematis ini dibuat untuk menilai akurasi diagnostik USG, mamografi dan MRI dalam mendeteksi lesi kanker payudara pada pengguna implan payudara. Metode: Pencarian sistematis dilakukan pada Januari 2022 untuk mengidentifikasi studi yang menilai akurasi diagnostik USG, mamografi dan MRI dalam mendeteksi lesi kanker payudara dengan referensi baku pemeriksaan patologi anatomi dengan menggunakan data dasar Scopus, PubMed, jurnal dan riset nasional, hand searching serta grey literature. Nilai sensitivitas dan spesifisitas pada masing-masing uji indeks diekstraksi. Penilaian kualitas metodologi studi dilakukan menggunakan QUADAS-2. Hasil: Tiga belas studi diidentifikasi. Nilai sensitivitas USG terendah 62%, tertinggi 95%, spesifitas 93%. Nilai sensitivitas mamografi terendah 22%, tertinggi 80%, spesifitas 100%. Sementara itu, nilai sensitivitas MRI terendah 86%, tertinggi 100% dengan spesifisitas terendah 17%, tertinggi 75%. Sepuluh studi menunjukkan risiko bias tinggi pada salah satu domain, tiga studi di antaranya menunjukkan risiko bias tinggi pada domain yang lain. Kesimpulan: Akurasi diagnostik modalitas USG, mamografi dan MRI dalam mendeteksi lesi kanker payudara pada pengguna implan payudara sangat bervariasi.
Background: Breast cancer is cancer with the highest incidence and leading cause of cancer death among women worldwide. Breast implant use for post mastectomy patients and for cosmetic purposes is also increasing. Ultrasonography, mammography and MRI are imaging modalities mostly used to detect breast lesions in patients with breast implants. Ultrasound role is still unclear; mammography has been reported to have lower sensitivity while MRI availibility is still limited and highly cost. This systematic review is written to analyze diagnostic accuracy of ultrasound, mammography and MRI in detecting breast cancer in patients with breast implants. Methods: Studies contained diagnostic accuracy of ultrasound, mammography and MRI in detecting breast cancer lesions with pathological examination as reference standard were identified. Scopus, PubMed, national journals and research, hand searching and grey literatures were systematically searched through January 2022. Sensitivity and specificity value of each index tests from eligible studies is extracted. Methodological quality was assessed using QUADAS-2. Results: Thirteen studies were identified. The lowest and the highest sensitivity value are 62% and 95 % for ultrasound, 22% and 80 % for mammography, 86% and 100% for MRI while specificity value are 93% for ultrasound, 100% for mammography, the lowest and the highest of MRI 17% and 75%, respectively. Ten studies demonstrated high risks of bias in one domain with three of them also have high risk of bias in another domain. Conclusion: Diagnostic accuracy of ultrasound, mammography and MRI to detect breast cancer in patients with breast implants is varied. |
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