Effect of Arrival of Prior Mammograms on Recall Negation for Screening Mammograms Performed With Digital Breast Tomosynthesis in a Clinical Setting

Abstract Objective To investigate whether having the nipple imaged in profile was associated with breast characteristics or compression parameters, and whether it affected selected outcomes in screening with standard digital mammography or digital breast tomosynthesis. Methods In this IRB-approved retrospective study, results from 87 450 examinations (174 900 breasts) performed as part of BreastScreen Norway, 2016–2019, were compared by nipple in profile status and screening technique using descriptive statistics and generalized estimating equations. Unadjusted and adjusted odds ratios with 95% confidence intervals (95% CIs) were estimated for outcomes of interest, including age, breast volume, volumetric breast density, and compression force as covariates. Results Achieving the nipple in profile versus not in profile was associated with lower breast volume (845.1 cm3 versus 1059.9 cm3, P < 0.01) and higher mammographic density (5.6% versus 4.4%, P < 0.01). Lower compression force and higher compression pressure were applied to breasts with the nipple in profile (106.6 N and 11.5 kPa) compared to the nipple not in profile (110.8 N and 10.5 kPa, P < 0.01 for both). The adjusted odds ratio was 0.95 (95% CI: 0.88–1.02; P = 0.15) for recall and 0.92 (95% CI: 0.77–1.10; P = 0.36) for screen-detected cancer for nipple in profile versus not in profile. Conclusion Breast characteristics and compression parameters might hamper imaging of the nipple in profile. However, whether the nipple was in profile or not on the screening mammograms did not influence the odds of recall or screen-detected cancer, regardless of screening technique.

Download Full-text

Can Digital Breast Tomosynthesis Replace Conventional Diagnostic Mammography Views for Screening Recalls Without Calcifications? A Comparison Study in a Simulated Clinical Setting

American Journal of Roentgenology ◽

10.2214/ajr.12.8881 ◽

2013 ◽

Vol 200 (2) ◽

pp. 291-298 ◽

Cited By ~ 77

Author(s):

Kathleen R. Brandt ◽

Daniel A. Craig ◽

Tanya L. Hoskins ◽

Tara L. Henrichsen ◽

Emily C. Bendel ◽

...

Keyword(s):

Clinical Setting ◽

Digital Breast Tomosynthesis ◽

Comparison Study ◽

Breast Tomosynthesis ◽

Diagnostic Mammography

Download Full-text

Benefits of digital breast tomosynthesis: A lesion-level analysis

Journal of Medical Screening ◽

10.1177/0969141320978267 ◽

2020 ◽

pp. 096914132097826

Author(s):

Tali Amir ◽

Emily B Ambinder ◽

Susan C Harvey ◽

Eniola T Oluyemi ◽

Mary K Jones ◽

...

Keyword(s):

Digital Breast Tomosynthesis ◽

Recall Rate ◽

Architectural Distortion ◽

Screening Mammogram ◽

Diagnostic Challenge ◽

Breast Tomosynthesis ◽

Full Field ◽

Lesion Type ◽

Lesion Level ◽

Screening Mammograms

Objective To compare outcome metrics of digital breast tomosynthesis (DBT) breast cancer screening with full-field digital mammogram (FFDM); specifically, to compare recall rates by the type of recalled finding, and to assess if screening with DBT versus FFDM changes biopsy recommendations and if the likelihood of malignancy varied by lesion type, if detected on DBT or FFDM screening mammogram. Methods The outcomes of 22,055 FFDM and DBT screening mammograms were retrospectively reviewed. The exams were performed at an academic institution between August 2015 and September 2016. Performance of screening with FFDM versus DBT was compared in terms of recall rate and percentage of recalled lesions resulting in a cancer diagnosis, with subset analyses performed for specific mammographic findings. Results The recall rate was 10.6% for FFDM and 8.0% for DBT ( p < 0.001). Architectural distortion was more likely to be recalled on DBT screening than FFDM ( p = 0.002), and was associated with an increased likelihood of malignancy ( p = 0.008). Asymmetries were less likely to be recalled on DBT than FFDM ( p < 0.001) screening mammogram, but more likely to be recommended for biopsy when detected on DBT. Calcifications more frequently required short-term follow-up or biopsy on both DBT and FFDM. Conclusions DBT screening confers an advantage in detection of architectural distortion representing malignancy. Recall rate of asymmetries are reduced with screening DBT, probably due to reduction of tissue superimposition. Calcifications pose a particularly difficult diagnostic challenge for breast imagers, regardless of screening mammogram type.

Download Full-text

Diagnostic Usefulness of Synthetic MMG (SMMG) with DBT (Digital Breast Tomosynthesis) for Clinical Setting in Breast Cancer Screening

Breast Imaging - Lecture Notes in Computer Science ◽

10.1007/978-3-319-41546-8_8 ◽

2016 ◽

pp. 59-67 ◽

Cited By ~ 2

Author(s):

Nachiko Uchiyama ◽

Mari Kikuchi ◽

Minoru Machida ◽

Yasuaki Arai ◽

Ryusuke Murakami ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Clinical Setting ◽

Digital Breast Tomosynthesis ◽

Breast Tomosynthesis ◽

Diagnostic Usefulness

Download Full-text

Impact of prior mammograms on combined reading of digital mammography and digital breast tomosynthesis

Acta Radiologica ◽

10.1177/0284185116647211 ◽

2016 ◽

Vol 58 (2) ◽

pp. 148-155 ◽

Cited By ~ 2

Author(s):

Won Hwa Kim ◽

Jung Min Chang ◽

Hye Ryoung Koo ◽

Mirinae Seo ◽

Min Sun Bae ◽

...

Keyword(s):

Digital Mammography ◽

Breast Imaging ◽

Diagnostic Performance ◽

Characteristic Curve ◽

Digital Breast Tomosynthesis ◽

Breast Tomosynthesis ◽

Relative Contribution ◽

Prior Mammograms ◽

Prior Mammogram ◽

Higher Sensitivity

Background Although digital breast tomosynthesis (DBT) is an emerging technique yielding higher sensitivity and specificity compared to digital mammography (DM) alone, relative contribution of prior mammograms on the interpretation of DBT combined with DM has not been investigated. Purpose To retrospectively compare the diagnostic performances of DM, DM + DBT, and DM + DBT with prior mammograms. Material and Methods Three breast radiologists independently reviewed images of 116 patients with 24 cancers in the sequential order of DM, DM + DBT, and DM + DBT with prior mammograms using Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Results The average areas under the receiver operating characteristic curve (AUC) of DM, DM + DBT, and DM + DBT with prior mammograms were 0.712, 0.777, and 0.816, respectively. Adding prior mammograms did not significantly affect the AUC of DM + DBT ( P = 0.108), whereas adding DBT significantly increased the AUC of DM ( P = 0.009). Sensitivity for DM, DM + DBT, and DM + DBT with prior mammograms was 58.3%, 69.4%, and 69.4%, and specificities were 84.1%, 85.9%, and 93.8%, respectively. Addition of DBT significantly increased the sensitivity ( P = 0.0090) of DM. Prior mammograms significantly improved the specificity of DM + DBT ( P = 0.0004), whereas adding prior mammogram did not affect sensitivity of DM + DBT ( P = 1.000). Conclusion DBT significantly increases the overall sensitivity and diagnostic performance of DM. Prior mammograms significantly increase the specificity of DM + DBT but have no significant effect on sensitivity and overall diagnostic performance.

Download Full-text