Quantitative versus qualitative analysis of breast lesions using mammography and ultrasonography: A systematic review and meta-analysis

Introduction: Mammography and ultrasound are common tools for the diagnosis of breast cancer. Quantitative analysis of imperceivable information from their images can be incorporated into breast cancer diagnosis. However, the impact of quantitative information on diagnostic performance is poorly understood. Methods: A systematic review was conducted across PubMed, CINAHL, Web of Science, SCOPUS, and EBSCO databases to identify English-language studies comparing qualitative and quantitative image analyses for breast lesions. Eligible studies were independently screened and selected by two reviewers. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were extracted and pooled using Review Manager 5.4 and MetaDisc 1.4. The quality of evidence was assessed using GRADE criteria. Results: Six studies were included. For qualitative analysis, pooled sensitivity and specificity were 0.85 (95 % CI: 0.78–0.91) and 0.78 (0.71–0.84), respectively, with an AUC of 0.89 (0.86–0.91). Quantitative analysis demonstrated similar sensitivity, 0.84 (0.77–0.90), but significantly higher specificity, 0.90 (0.85–0.94), with an AUC of 0.92 (0.89–0.94). The 12-percentage point increase in specificity for quantitative methods was statistically and clinically significant (Z = −2.97, p = 0.003). Conclusion: Quantitative image analysis shows comparable sensitivity, but superior specificity compared to qualitative approaches in breast imaging. These findings suggest that quantitative methods may improve diagnostic accuracy and reduce false positives in the assessment of breast lesions. Implications for practice: The higher specificity of quantitative image analysis may reduce unnecessary breast biopsies there by improve patient care and resource utilization.