{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:20:27Z","timestamp":1787642427613,"version":"build-2736575974"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To identify screening intervals and BI-RADS\u2013specific management pathways that balance cancer detection yield against recall burden in ultrasound-based breast cancer screening in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed 1,694,838 ultrasound examinations reported with BI-RADS (2018\u20132023). For BI-RADS 1\/2, inter-screen intervals were evaluated by recall rate, cancer detection rate (CDR), positive predictive value (PPV), and early-stage proportion. For BI-RADS 0\/3\/4\/5, we assessed associations between biopsy waiting time and PPV\/early-stage proportion, and examined imaging follow-up outcomes for BI-RADS 4A.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 337,497 screening intervals following BI-RADS 1\/2, longer intervals were associated with higher CDR (0.13\u20130.54 per 1,000) but higher recall (17.4%\u201322.1%) and lower PPV (61.1%\u201331.0%), while early-stage proportion remained stable. The interval that best balanced yield and downstream burden was 13\u201324 months for women aged\u2009\u2265\u200940 years and 25\u201336 months for women aged\u2009&lt;\u200940 years, achieving higher detection yield and PPV without a material increase in recall. Among 1,949 BI-RADS 4\/5 biopsies, PPV was low for 4A (12.3%\u201325.0%), declined markedly with biopsy delay for 4B (60.5% to 25.0%), and remained consistently high for 4C\/5 (&gt;\u200960%\/&gt;93%). Among BI-RADS 4A lesions 64.7% (10,909\/16,871) showed imaging downgrading during follow-up. In 487 BI-RADS 3 cases undergoing biopsy, delayed biopsy increased PPV without changing early-stage proportion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 2-year screening interval is recommended for women aged 40\u201364 years, extendable to 3 years for those aged\u2009&lt;\u200940. Prompt biopsy is warranted for BI-RADS 4B\/4C\/5. The high image downgrade rate of BI-RADS 4A suggests overestimation and supports imaging-based triage, requiring further validation. Imaging surveillance is preferable for BI-RADS 3 lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-026-08045-w","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:52:05Z","timestamp":1785991925000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimising screening intervals and BI-RADS management pathways in ultrasound-based breast cancer screening: real-world evidence from Shenzhen (2018\u20132023)"],"prefix":"10.1007","volume":"218","author":[{"given":"Wanyi","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangying","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyan","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9294-0005","authenticated-orcid":false,"given":"Fanghui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"8045_CR1","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1001\/jama.2024.5534","volume":"331","author":"WK Nicholson","year":"2024","unstructured":"Nicholson WK, Silverstein M, Wong JB et al (2024) Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. 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