Digital Breast Tomosynthesis as a Tool in Confirming Negative Surgical Margins in Non-palpable Breast Lesions

AbstractThis study aims to assess the diagnostic accuracy of digital breast tomosynthesis in combination with full field digital mammography (DBT + FFDM) in the charaterisation of Breast Imaging-reporting and Data System (BI-RADS) category 3, 4 and 5 lesions. Retrospective cross-sectional study of 390 patients with BI-RADS 3, 4 and 5 mammography with available histopathology examination results were recruited from in a single center of a multi-ethnic Asian population. 2 readers independently reported the FFDM and DBT images and classified lesions detected (mass, calcifications, asymmetric density and architectural distortion) based on American College of Radiology-BI-RADS lexicon. Of the 390 patients recruited, 182 malignancies were reported. Positive predictive value (PPV) of cancer was 46.7%. The PPV in BI-RADS 4a, 4b, 4c and 5 were 6.0%, 38.3%, 68.9%, and 93.1%, respectively. Among all the cancers, 76% presented as masses, 4% as calcifications and 20% as asymmetry. An additional of 4% of cancers were detected on ultrasound. The sensitivity, specificity, PPV and NPV of mass lesions detected on DBT + FFDM were 93.8%, 85.1%, 88.8% and 91.5%, respectively. The PPV for calcification is 61.6% and asymmetry is 60.7%. 81.6% of cancer detected were invasive and 13.3% were in-situ type. Our study showed that DBT is proven to be an effective tool in the diagnosis and characterization of breast lesions and supports the current body of literature that states that integrating DBT to FFDM allows good characterization of breast lesions and accurate diagnosis of cancer.

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Radiomic features analysis by digital breast tomosynthesis and contrast-enhanced dual-energy mammography to detect malignant breast lesions

Biomedical Signal Processing and Control ◽

10.1016/j.bspc.2019.101568 ◽

2019 ◽

Vol 53 ◽

pp. 101568 ◽

Cited By ~ 1

Author(s):

Roberta Fusco ◽

Paolo Vallone ◽

Salvatore Filice ◽

Vincenza Granata ◽

Teresa Petrosino ◽

...

Keyword(s):

Digital Breast Tomosynthesis ◽

Dual Energy ◽

Breast Lesions ◽

Breast Tomosynthesis ◽

Contrast Enhanced ◽

Malignant Breast

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Comparing the diagnostic efficacy of digital breast tomosynthesis with full-field digital mammography using BI-RADS scoring

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00421-4 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Rana M. Naeim ◽

Rania A. Marouf ◽

Merhan A. Nasr ◽

Marwa E. Abd El-Rahman

Keyword(s):

Breast Cancer ◽

Diagnostic Accuracy ◽

Digital Mammography ◽

Digital Breast Tomosynthesis ◽

Breast Lesions ◽

Breast Tomosynthesis ◽

Full Field ◽

Dense Breasts ◽

Full Field Digital Mammography ◽

Diagnostic Indices

Abstract Background Mammography has been the mainstay for the detection of breast cancer over decades. It has gradually advanced from screen film to full-field digital mammography. Tomosynthesis has evolved as advanced imaging for early diagnosis of breast lesions with a promising role in both diagnostic and screening settings, particularly in dense and treated breasts. Results This study included 90 female patients according to our inclusion criteria. All patients perform full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and were classified according to breast density and age groups. Breast imaging reporting and data system (BI-RADS) scoring was assigned for each case. This was correlated with the final diagnosis; the diagnostic indices of mammography were a sensitivity of 64.44%, a specificity of 77.78%, a positive predictive value (PPV) 74.63%, a negative predictive value (NPV) of 68.63%, and a diagnostic accuracy of 71.11%. Diagnostic indices of DBT were a sensitivity of 100%, a specificity of 97.77%, PPV 97.78%, NPV 100%, and diagnostic accuracy of 97.7%. In patients with dense breasts American College of Radiology (ACR) (c and d), 61% of cases had changed their BIRADS scoring with the addition of tomosynthesis. Yet, in non-dense breast ACR (a and b), 45% of cases had changed BIRADS scoring with the addition of DBT to FFDM. Conclusion DBT is a promising imaging modality offering better detection and characterization of different breast abnormalities, especially in young females, and those with dense breasts with an increase of sensitivity and specificity than FFDM. This leads to a reduction in the recalled cases, negative biopsies, and assessing the efficacy of therapy as it enables improving detection of breast cancer and different breast lesions not visualized by conventional mammography

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One view or two views for wide-angle tomosynthesis with synthetic mammography in the assessment setting?

European Radiology ◽

10.1007/s00330-021-08079-2 ◽

2021 ◽

Author(s):

Paola Clauser ◽

Pascal A. T. Baltzer ◽

Panagiotis Kapetas ◽

Ramona Woitek ◽

Michael Weber ◽

...

Keyword(s):

Digital Mammography ◽

Detection Rate ◽

Diagnostic Performance ◽

Digital Breast Tomosynthesis ◽

Rate Sensitivity ◽

Breast Lesions ◽

Wide Angle ◽

Breast Tomosynthesis ◽

Lesion Type ◽

Sensitivity Specificity

Abstract Objectives To evaluate the diagnostic performance in the assessment setting of three protocols: one-view wide-angle digital breast tomosynthesis (WA-DBT) with synthetic mammography (SM), two-view WA-DBT/SM, and two-view digital mammography (DM). Methods Included in this retrospective study were patients who underwent bilateral two-view DM and WA-DBT. SM were reconstructed from the WA-DBT data. The standard of reference was histology and/or 2 years follow-up. Included were 205 women with 179 lesions (89 malignant, 90 benign). Four blinded readers randomly evaluated images to assess density, lesion type, and level of suspicion according to BI-RADS. Three protocols were evaluated: two-view DM, one-view (mediolateral oblique) WA-DBT/SM, and two-view WA-DBT/SM. Detection rate, sensitivity, specificity, and accuracy were calculated and compared using multivariate analysis. Reading time was assessed. Results The detection rate was higher with two-view WA-DBT/SM (p = 0.063). Sensitivity was higher for two-view WA-DBT/SM compared to two-view DM (p = 0.001) and one-view WA-DBT/SM (p = 0.058). No significant differences in specificity were found. Accuracy was higher with both one-view WA-DBT/SM and two-view WA-DBT/SM compared to DM (p = 0.003 and > 0.001, respectively). Accuracy did not differ between one- and two-view WA-DBT/SM. Two-view WA-DBT/SM performed better for masses and asymmetries. Reading times were significantly longer when WA-DBT was evaluated. Conclusions One-view and two-view WA-DBT/SM can achieve a higher diagnostic performance compared to two-view DM. The detection rate and sensitivity were highest with two-view WA-DBT/SM. Two-view WA-DBT/SM appears to be the most appropriate tool for the assessment of breast lesions. Key Points • Detection rate with two-view wide-angle digital breast tomosynthesis (WA-DBT) is significantly higher than with two-view digital mammography in the assessment setting. • Diagnostic accuracy of one-view and two-view WA-DBT with synthetic mammography (SM) in the assessment setting is higher than that of two-view digital mammography. • Compared to one-view WA-DBT with SM, two-view WA-DBT with SM seems to be the most appropriate tool for the assessment of breast lesions.

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Accuracy of GE digital breast tomosynthesis versus supplementary mammographic views for diagnosis of screen-detected soft tissue breast lesions

Breast Cancer Research ◽

10.1186/bcr3757 ◽

2015 ◽

Vol 17 (S1) ◽

Author(s):

Eleanor Cornford ◽

Anne Turnbull ◽

Jonathan James ◽

Rachel Tsang ◽

Tayeba Akram ◽

...

Keyword(s):

Soft Tissue ◽

Digital Breast Tomosynthesis ◽

Breast Lesions ◽

Breast Tomosynthesis

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Detection and characterization of breast lesions in a selective diagnostic population: diagnostic accuracy study for comparison between one-view digital breast tomosynthesis and two-view full-field digital mammography

British Journal of Radiology ◽

10.1259/bjr.20150743 ◽

2016 ◽

Vol 89 (1062) ◽

pp. 20150743 ◽

Cited By ~ 10

Author(s):

Eun Young Chae ◽

Hak Hee Kim ◽

Joo Hee Cha ◽

Hee Jung Shin ◽

Woo Jung Choi

Keyword(s):

Diagnostic Accuracy ◽

Digital Mammography ◽

Digital Breast Tomosynthesis ◽

Breast Lesions ◽

Diagnostic Accuracy Study ◽

Breast Tomosynthesis ◽

Full Field ◽

Full Field Digital Mammography ◽

Accuracy Study

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Diagnostic Accuracy of Digital Breast Tomosynthesis in the Evaluation of Palpable Breast Abnormalities

Academic Radiology ◽

10.1016/j.acra.2017.09.016 ◽

2018 ◽

Vol 25 (3) ◽

pp. 297-304

Author(s):

Jeffrey R. Hawley ◽

Justine K. Kang-Chapman ◽

Sarah E. Bonnet ◽

Amy L. Kerger ◽

Clayton R. Taylor ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Digital Breast Tomosynthesis ◽

Breast Tomosynthesis ◽

Palpable Breast

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Comparison of Digital Breast Tomosynthesis and Digital Mammography for Detection of Breast Cancer in Kuwaiti Women

Medical Principles and Practice ◽

10.1159/000495753 ◽

2018 ◽

Vol 28 (1) ◽

pp. 10-15 ◽

Cited By ~ 1

Author(s):

Akram M. Asbeutah ◽

Nouralhuda Karmani ◽

AbdulAziz A. Asbeutah ◽

Yasmin A. Echreshzadeh ◽

Abdullah A. AlMajran ◽

...

Keyword(s):

Breast Cancer ◽

Sensitivity And Specificity ◽

Digital Mammography ◽

Breast Imaging ◽

Characteristic Curve ◽

Digital Breast Tomosynthesis ◽

Breast Lesions ◽

Breast Tomosynthesis ◽

Kappa Test ◽

Significant Difference

Objective: To investigate the sensitivity and specificity of digital mammography (DM) and digital breast tomosynthesis (DBT) for the detection of breast cancer in comparison to histopathology findings. Subjects and Methods: We included 65 breast lesions in 58 women, each detected by two diagnostic mammography techniques – DM and DBT using Senographe Essential (GE Healthcare, Buc, France) – and subsequently confirmed by histopathology. The Breast Imaging Reporting and Data System was used for characterizing the lesions. Results: The average age of women was 48.3 years (range 26–81 years). There were 34 malignant and 31 benign breast lesions. The sensitivity of DM and DBT was 73.5 and 100%, respectively, while the specificity was 67.7 and 94%, respectively. Receiver operating characteristic curve analysis showed an overall diagnostic advantage of DBT over DM, with a significant difference between DBT and DM (p < 0.001). By performing Cohen’s kappa test, we found that there was a strong level of agreement according to Altman guidelines between DBT and histopathology findings (0.97), but a weak agreement between DM and histopathology findings (0.47). Conclusion: DBT improves the clinical accuracy of mammography by increasing both sensitivity and specificity. We believe that this improvement is due to improved image visibility and quality. These results could be of interest to health care institutions as they may impact their decision on whether to upgrade to DBT not only for diagnosis, but also for screening.

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