Precisión diagnóstica de la ecografía mamaria suplementaria en el cribado de cáncer de mama en mujeres con mamas densas
DOI:
https://doi.org/10.66201/ss.v1.20Palabras clave:
Cribado de Cáncer de Mama, Ecografía Automatizada, Tasa de Detección Incremental, Falsos Positivos, Ecografía Mamaria Suplementaria, Mamas DensasResumen
Antecedentes: El cáncer de mama constituye el tumor maligno más frecuente en mujeres a escala mundial. La mamografía es el único método de cribado con evidencia de reducción de mortalidad, pero su sensibilidad disminuye en presencia de tejido mamario denso. Esta limitación justifica la evaluación de modalidades de imagen suplementarias.
Métodos: Se realizó una revisión narrativa de la literatura, incluyendo estudios publicados entre enero 2020 y abril 2026 que evaluaron la ecografía mamaria —de mano (HHUS) o automatizada (ABUS)— como modalidad suplementaria a la mamografía en mujeres con mamas densas (categorías C y D del ACR BI-RADS).
Resultados: La ecografía suplementaria incrementa la tasa de detección incremental de cáncer (IDCR) entre 1,1 y 7,0 por 1000 mujeres exploradas respecto a la mamografía sola. El ensayo DBTUST registró una IDCR de 1,1/1000 tras ecografía suplementaria a tomosíntesis. Las experiencias canadienses reportaron IDCR de 6,1–7,0/1000, con la mayoría de las lesiones detectadas en estadio I. Un metaánálisis confirmó un incremento del 51,5 % en la detección global con ABUS respecto a mamografía sola. Un ensayo clínico aleatorizado multicéntrico chino demostró superioridad diagnóstica de la ABUS respecto a la HHUS (AUC 0,86 vs. 0,72). La tasa de falsos positivos aumentó entre un 4,5 % y un 14,9 % según la modalidad.
Conclusión: La ecografía suplementaria mejora de manera consistente la detección de cáncer en mujeres con mamas densas, especialmente cuando el acceso a resonancia magnética es limitado. La ABUS reduce la variabilidad operador-dependiente y muestra resultados prometedores a escala poblacional.
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Derechos de autor 2026 Bruna Eduarda Loli, Emanuelle De Melo Lacerda, Jose Mauricio Sivirino Silva, Andrea Paola Britos de Chaux (Autor/a)
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
