scholarly journals Screening Digital Breast Tomosynthesis: Radiation Dose Among Patients With Breast Implants

2021 ◽  
Author(s):  
Nhu Q Vu ◽  
Curran Bice ◽  
John Garrett ◽  
Colin Longhurst ◽  
Daryn Belden ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Cancer Detection ◽  
Digital Breast Tomosynthesis ◽  
Breast Implants ◽  
Recall Rate ◽  
Screening Mammography ◽  
Chi Square ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Significant Difference

Abstract Objective To compare the mean glandular dose (MGD), cancer detection rate (CDR), and recall rate (RR) among screening examinations of patients with breast implants utilizing various digital breast tomosynthesis (DBT)-based imaging protocols. Methods This IRB-approved retrospective study included 1998 women with breast implants who presented for screening mammography between December 10, 2013 and May 29, 2020. Images were obtained using various protocol combinations of DBT and 2D digital mammography. Data collected included MGD, implant type and position, breast density, BI-RADS final assessment category, CDR, and RR. Statistical analysis utilized type II analysis of variance and the chi-square test. Results The highest MGD was observed in the DBT only protocol, while the 2D only protocol had the lowest (10.29 mGy vs 5.88 mGy, respectively). Statistically significant difference in MGD was observed across protocols (P < 0.0001). The highest per-view MGD was among DBT full-field (FF) views in both craniocaudal and mediolateral oblique projections (P < 0.0001). No significant difference was observed in RR among protocols (P = 0.17). The combined 2D (FF only) + DBT implant-displaced (ID) views protocol detected the highest number of cancers (CDR, 7.2 per 1000), but this was not significantly different across protocols (P = 0.48). Conclusion The combination of 2D FF views and DBT ID views should be considered for women with breast implants in a DBT-based screening practice when aiming to minimize radiation exposure without compromising the sensitivity of cancer detection. Avoidance of DBT FF in this patient population is recommended to minimize radiation dose.

scholarly journals Initial Experience with Combination Digital Breast Tomosynthesis Plus Full Field Digital Mammography or Full Field Digital Mammography Alone in the Screening Environment

2014 ◽  
Vol 4 ◽  
pp. 9 ◽  
Author(s):  
Stamatia Destounis ◽  
Andrea Arieno ◽  
Renee Morgan
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Screening Mammography ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Significant Difference ◽  
History Of

Objectives: Initial review of patients undergoing screening mammography imaged with a combination of digital breast tomosynthesis (DBT) plus full field digital mammography (FFDM) compared with FFDM alone. Materials and Methods: From June 2011 to December 2011, all patients presenting for routine screening mammography were offered a combination DBT plus FFDM exam. Under institutional review board approval, we reviewed 524 patients who opted for combination DBT plus FFDM and selected a sample group of 524 FFDM screening exams from the same time period for a comparative analysis. The χ2 (Chi-square) test was used to compare recall rates, breast density, personal history of breast cancer, and family history of breast cancer between the two groups. Results: Recall rate for FFDM, 11.45%, was significantly higher (P < 0001) than in the combination DBT plus FFDM group (4.20%). The biopsy rate in the FFDM group was 2.29% (12/524), with a cancer detection rate of 0.38% (2/524, or 3.8 per 1000) and positive predictive value (PPV) of 16.7% (2/12). The biopsy rate for the DBT plus FFDM group was 1.14% (n = 6/524), with a cancer detection rate 0.57% (n = 3/524, or 5.7 per 1000) and PPV of 50.0% (n = 3/6). Personal history of breast cancer in the FFDM group was significantly lower (P < 0.0001) than in the combination DBT plus FFDM group; 2.5% and 5.7%, respectively. A significant difference in family history of breast cancer (P < 0.0001) was found, with a higher rate in the combination DBT plus FFDM group (36.0% vs. 53.8%). There was a significant difference between the combination DBT plus FFDM group and FFDM alone group, when comparing breast density (P < 0.0147, 61.64% vs. 54.20% dense breasts, respectively) with a higher rate of dense breasts in the DBT plus FFDM group. In follow-up, one cancer was detected within one year of normal screening mammogram in the combination DBT plus FFDM group. Conclusion: Our initial experience found the recall rate in the combination DBT plus FFDM group was significantly lower than in the FFDM alone group, despite the fact that the combination DBT plus FFDM group had additional risk factors.

scholarly journals Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

Radiology ◽  
2016 ◽  
Vol 278 (3) ◽  
pp. 698-706 ◽  
Author(s):  
Richard E. Sharpe ◽  
Shambavi Venkataraman ◽  
Jordana Phillips ◽  
Vandana Dialani ◽  
Valerie J. Fein-Zachary ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Screening Program ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Population Based ◽  
Cancer Detection Rate ◽  
Breast Tomosynthesis

Comparison of Microcalcifications Detection and Characterization in Digital Breast Tomosynthesis (DBT) With Synthesized 2D Mammography (SM) versus DBT with Full-Field Digital Mammography (FFDM)

2021 ◽  
Vol 104 (9) ◽  
pp. 1503-1510
Keyword(s):  
Radiation Dose ◽  
Sensitivity And Specificity ◽  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Full Field Digital Mammography

Background: Synthesized 2D mammography (SM) has been invented to help lower the radiation dose by circumventing the need for acquiring full-field digital mammography (FFDM) when digital breast tomosynthesis (DBT) is performed. Prior studies have compared microcalcifications detection and characterization in FFDM with SM or with DBT alone. Only few studies have compared DBT plus SM and DBT plus FFDM. Objective: To determine the performance of DBT with SM versus DBT with FFDM in detection and characterization of microcalcifications. Materials and Methods: Three hundred three paired examinations of 2D plus DBT images in the same session were performed. Fifty-five biopsyproven malignancy, 198 biopsy-proven benign microcalcifications, and 50 randomly selected negative screening studies were retrospectively reviewed by two radiologists. Comparison of sensitivity and specificity between the two modalities were performed. Results: From the 55 malignant microcalcifications, three cases were missed by DBT with FFDM but detected and correctly categorized as malignant by DBT with SM. Only one case of malignant microcalcifications was not detected by DBT with SM, and the present case was also miscategorized as benign by DBT with FFDM. There were no statistically significant differences in both detections (p=0.42), and characterization (p=0.65) of microcalcification between both modalities. In DBT with SM, the sensitivity was higher, and the specificity was lower for both detection and characterization of microcalcification when compared to DBT with FFDM. Conclusion: DBT in combination with SM is comparable to DBT in combination with FFDM for detection and characterization of microcalcifications. Keywords: Synthesized 2D mammography; Full-field digital mammography; Digital breast tomosynthesis; Microcalcifications detection and characterization

Benefits of digital breast tomosynthesis: A lesion-level analysis

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.

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