scholarly journals The Adjunctive Digital Breast Tomosynthesis in Diagnosis of Breast Cancer

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Tsung-Lung Yang ◽  
Huei-Lung Liang ◽  
Chen-Pin Chou ◽  
Jer-Shyung Huang ◽  
Huay-Ben Pan
Keyword(s):  
Breast Cancer ◽  
Diagnostic Performance ◽  
Digital Breast Tomosynthesis ◽  
Subjective Assessment ◽  
Architectural Distortion ◽  
Breast Cancers ◽  
Chi Square ◽  
Breast Tomosynthesis ◽  
Chi Square Test ◽  
Mass Lesions

Purpose. To compare the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for breast cancers.Materials and Methods. Fifty-seven female patients with pathologically proved breast cancer were enrolled. Three readers gave a subjective assessment superiority of the index lesions (mass, focal asymmetry, architectural distortion, or calcifications) and a forced BIRADS score, based on DM reading alone and with additional DBT information. The relevance between BIRADS category and index lesions of breast cancer was compared by chi-square test.Result. A total of 59 breast cancers were reviewed, including 17 (28.8%) mass lesions, 12 (20.3%) focal asymmetry/density, 6 (10.2%) architecture distortion, 23 (39.0%) calcifications, and 1 (1.7%) intracystic tumor. Combo DBT was perceived to be more informative in 58.8% mass lesions, 83.3% density, 94.4% architecture distortion, and only 11.6% calcifications. As to the forced BIRADS score, 84.4% BIRADS 0 on DM was upgraded to BIRADS 4 or 5 on DBT, whereas only 27.3% BIRADS 4A on DM was upgraded on DBT, as BIRADS 4A lesions were mostly calcifications. A significantPvalue (<0.001) between the BIRADS category and index lesions was noted.Conclusion. Adjunctive DBT gives exquisite information for mass lesion, focal asymmetry, and/or architecture distortion to improve the diagnostic performance in mammography.

DETECTION OF BREAST CANCERS REPRESENTED AS ARCHITECTURAL DISTORTION: A COMPARISON OF FULL-FIELD DIGITAL MAMMOGRAPHY AND DIGITAL BREAST TOMOSYNTHESIS

2021 ◽  
Vol 74 (7) ◽  
pp. 1674-1679
Author(s):  
Tetiana M. Babkina ◽  
Andrii V. Gurando ◽  
Tetiana M. Kozarenko ◽  
Viacheslav R. Gurando ◽  
Vadim V. Telniy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Architectural Distortion ◽  
Breast Cancers ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Ductal Hyperplasia ◽  
History Of

The aim: The aim of our study was to determine if digital breast tomosynthesis improves breast cancer detection associated with architectural distortion in comparison with full-field digital mammography in the absence of appropriate history of trauma or surgery. Materials and methods: The overall rate of breast cancer involvement for the 34 patients with architectural distortion was 15 cases (44,1%) (invasive breast cancers, n=12 (36,4%); ductal cancer in situ, n= 3 (8,8%)) other findings associated with architectural distortion were high-risk lesions and benign findings (radial scar, n=5 (14,7%); sclerosing adenosis, n=9 (26,5%); typical lobular hyperplasia, n=3 (8,8%); typical ductal hyperplasia, n=2 cases (5,9%)). Results: Overall of 17/34 (50.0%) architectural distortions were identified at digital breast tomosynthesis that were missed at full-field digital mammography what was statistically significant difference ([95% CI, 2.56–7.45]; p=0.00001). Analysis of the results showed that sensitivity of full-field digital mammography for digital breast tomosynthesis detected breast cancers associated with architectural distortion was 53.3% [95% CI, 26.59% to 78.73%] and specificity was 52.63% [95% CI, 28.86% to 75.55%]. Conclusions: Our study suggests that digital breast tomosynthesis detects more breast cancers represented as architectural distortion which are occult on full-field digital mammography. Presence of microcalcifications within architectural distortion, in the absence of appropriate history of trauma or surgery, has a high likelihood of malignancy and obligatorily requires biopsy.

scholarly journals Posterior breast cancer: Mammographic and ultrasonographic features

2013 ◽  
Vol 70 (11) ◽  
pp. 1034-1038
Author(s):  
Ana Jankovic ◽  
Mirjan Nadrljanski ◽  
Vesna Plesinac-Karapandzic ◽  
Nebojsa Ivanovic ◽  
Zoran Radojicic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Color Doppler ◽  
Lobular Carcinoma ◽  
Architectural Distortion ◽  
Breast Cancers ◽  
Significant Difference ◽  
Diagnostic Mammography ◽  
Anatomical Localization ◽  
Mass Lesions

Background/Aim. Posterior breast cancers are located in the prepectoral region of the breast. Owing to this distinctive anatomical localization, physical examination and mammographic or ultrasonographic evaluation can be difficult. The purpose of the study was to assess possibilities of diagnostic mammography and breast ultrasonography in detection and differentiation of posterior breast cancers. Methods. The study included 40 women with palpable, histopathological confirmed posterior breast cancer. Mammographic and ultrasonographic features were defined according to Breast Imaging Reporting and Data System (BI-RADS) lexicon. Results. Based on standard two-view mammography 87.5%, of the cases were classified as BI-RADS 4 and 5 categories, while after additional mammographic views all the cases were defined as BIRADS 4 and 5 categories. Among 96 mammographic descriptors, the most frequent were: spiculated mass (24.0%), architectural distortion (16.7%), clustered microcalcifications (12.6%) and focal asymmetric density (12.6%). The differentiation of the spiculated mass was significantly associated with the possibility to visualize the lesion at two-view mammography (p = 0.009), without the association with lesion diameter (p = 0.083) or histopathological type (p = 0.055). Mammographic signs of invasive lobular carcinoma were significantly different from other histopathological types (architectural distortion, p = 0.003; focal asymmetric density, p = 0.019; association of four or five subtle signs of malignancy, p = 0.006). All cancers were detectable by ultrasonography. Mass lesions were found in 82.0% of the cases. Among 153 ultrasonographic descriptors, the most frequent were: irregular mass (15.7%), lobulated mass (7.2%), abnormal color Doppler signals (20.3%), posterior acoustic attenuation (18.3%). Ultrasonographic BI-RADS 4 and 5 categories were defined in 72.5% of the cases, without a significant difference among various histopathological types (p = 0.109). Conclusion. Standard two-view mammography followed by additional mammographic projections is an effective way to demonstrate the spiculated mass and to classify the prepectoral lesion as category BI-RADS 4 or 5. Additional ultrasonography can overcome the mimicry of invasive lobular breast carcinoma at mammography.

scholarly journals Radiomic Evaluations of the Diagnostic Performance of DM, DBT, DCE MRI, DWI, and Their Combination for the Diagnosisof Breast Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Shuxian Niu ◽  
Xiaoyu Wang ◽  
Nannan Zhao ◽  
Guanyu Liu ◽  
Yangyang Kan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Roc Curve ◽  
Diagnostic Performance ◽  
Digital Breast Tomosynthesis ◽  
Lasso Regression ◽  
Clinical Predictors ◽  
Breast Tomosynthesis ◽  
Clinical Model ◽  
Selection Operator ◽  
Radiomics Signature

ObjectivesThis study aims to evaluate digital mammography (DM), digital breast tomosynthesis (DBT), dynamic contrast-enhanced (DCE), and diffusion-weighted (DW) MRI, individually and combined, for the values in the diagnosis of breast cancer, and propose a visualized clinical-radiomics nomogram for potential clinical uses.MethodsA total of 120 patients were enrolled between September 2017 and July 2018, all underwent preoperative DM, DBT, DCE, and DWI scans. Radiomics features were extracted and selected using the least absolute shrinkage and selection operator (LASSO) regression. A radiomics nomogram was constructed integrating the radiomics signature and important clinical predictors, and assessed with the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).ResultsThe radiomics signature derived from DBT plus DM generated a lower area under the ROC curve (AUC) and sensitivity, but a higher specificity compared with that from DCE plus DWI. The nomogram integrating the combined radiomics signature, age, and menstruation status achieved the best diagnostic performance in the training (AUCs, nomogram vs. combined radiomics signature vs. clinical model, 0.975 vs. 0.964 vs. 0.782) and validation (AUCs, nomogram vs. combined radiomics signature vs. clinical model, 0.983 vs. 0.978 vs. 0.680) cohorts. DCA confirmed the potential clinical usefulness of the nomogram.ConclusionsThe DBT plus DM provided a lower AUC and sensitivity, but a higher specificity than DCE plus DWI for detecting breast cancer. The proposed clinical-radiomics nomogram has diagnostic advantages over each modality, and can be considered as an efficient tool for breast cancer screening.

scholarly journals Is Digital Breast Tomosynthesis Superior to Digital Mammography? A Preclinical Evaluation of Tumor Histopathological Markers Using Digital Breast Tomosynthesis

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Aysegul Altunkeser ◽  
Zeynep Fatma Arslan ◽  
Mehmet Ali Eryilmaz ◽  
Muslu Kazım Korez ◽  
Zeynep Bayramoğlu
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Mass Density ◽  
Digital Breast Tomosynthesis ◽  
Molecular Classification ◽  
Architectural Distortion ◽  
Ki 67 ◽  
Breast Tomosynthesis ◽  
Skin Changes ◽  
The Relationship

Background: Digital mammography (DM) and digital breast tomosynthesis (DBT) are important radiological modalities, which increase the survival of breast cancer patients. Breast cancer is a morphologically heterogeneous disease with various histopathological parameters and multiple receptors in its biological profile. Objectives: This study aimed to analyze the morphological features of invasive breast cancer on DM and DBT, to investigate the contribution of DBT to DM, to examine the association of DBT findings with pathological molecular subtypes, Bloom-Richardson grade, and Ki-67 index, and to determine the effect of breast parenchyma density on the relationship between DBT findings and hormone receptors. Patients and Methods: A total of 36 patients with malignant lesions were evaluated in this study. According to the American College of Radiology (ACR) classification, the lesion features were divided into subgroups based on DM and DBT, and the findings were compared. The relationships between DBT findings and the hormone receptor status, molecular classification, and Bloom-Richardson grade were also investigated, and the effect of density on these relationships was assessed. Results: The mean age of the patients (n = 36) was 53 years. Based on the comparison of DM and DBT findings, spiculated margins, mass density, architectural distortion, and microcalcifications were significantly more frequent in DBT. Lesions with indistinct margins on DM were observed as mass lesions with spiculated margins on DBT (P < 0.001). Regarding the relationship between DBT findings and hormone receptor status and Ki-67 proliferation index, in PR-positive patients, an irregular tumor shape was more common (89.7%). In PR-negative patients, skin changes and nipple retraction were more frequently seen (P = 0.03 for skin changes, and P = 0.049 for nipple retraction). Regarding the association between Bloom-Richardson grade and DBT findings, tumors with a higher grade were more likely to be associated with a high tumor density (P = 0.032). Also, considering the relationship between molecular classification and DBT findings, skin changes and nipple retraction were significantly more frequent in triple-negative masses compared to other subtypes (P = 0.011 for skin changes and P = 0.016 for nipple retraction). Conclusions: DBT is superior to DM, as it reveals the lesion margins, density, and architectural distortion more accurately. The majority of PR-positive tumors were irregular, while most PR-negative cases were round. The mass density also increased as the tumor grade increased. Skin change and nipple retraction were frequently seen in triple-negative tumors compared to other subtypes. Therefore, DBT is a promising diagnostic tool for showing molecular subtypes in dense breasts.

scholarly journals Lobular Breast Cancer Conspicuity on Digital Breast Tomosynthesis Compared to Synthesized 2D Mammography: A Multireader Study

2021 ◽  
Vol 7 (9) ◽  
pp. 185
Author(s):  
Giovanna Romanucci ◽  
Lisa Zantedeschi ◽  
Anna Ventriglia ◽  
Sara Mercogliano ◽  
Maria Vittoria Bisighin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Matched Pairs ◽  
Breast Cancers ◽  
Test Results ◽  
Lobular Breast Cancer ◽  
Point Scale ◽  
Breast Tomosynthesis ◽  
Invasive Lobular Breast Cancer

Objectives: To compare the conspicuity of lobular breast cancers at digital breast tomosynthesis (DBT) versus synthesized 2D mammography (synt2D). Materials and methods: Seventy-six women (mean age 61.2 years, range 50–74 years) submitted to biopsy in our institution, from 2019 to 2021, with proven invasive lobular breast cancer (ILC) were enrolled in this retrospective study. The participants underwent DBT and synt2D. Five breast radiologists, with different years of experience in breast imaging, independently assigned a conspicuity score (ordinal 6-point scale) to DBT and synt2D. Lesion conspicuity was compared, for each reader, between the synt2D overall conspicuity interpretation and DBT overall conspicuity interpretation using a Wilcoxon matched pairs test. Results: A total of 50/78 (64%) cancers were detected on both synt2D and DBT by all the readers, while 28/78 (26%) cancers where not recognized by at least one reader on synt2D. For each reader, in comparison with synt2D, DBT increased significantly the conspicuity of ILC (p < 0.0001). The raw proportion of high versus low conspicuity by modality confirmed that cancers were more likely to have high conspicuity at DBT than synt2D. Conclusions: ILCs were more likely to have high conspicuity at DBT than at synt2D, increasing the chances of the detection of ILC breast cancer.

Comparison of Call-Back Rates between Digital Mammography and Digital Breast Tomosynthesis

2019 ◽  
Vol 85 (8) ◽  
pp. 855-857
Author(s):  
Anthony M. Scott ◽  
Madison G. Lashley ◽  
Nicholas B. Drury ◽  
Paul S. Dale
Keyword(s):  
Breast Cancer ◽  
Ultrasound Imaging ◽  
Digital Mammography ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Data System ◽  
Screening Tools ◽  
Radiographic Imaging ◽  
Breast Cancers ◽  
Breast Tomosynthesis

The effect of mammographic screening on the natural history and evolution of breast cancer treatment cannot be overstated; however, despite intensive and resource consuming screening, advanced breast cancer is still diagnosed frequently. The development of three-dimensional mammography or digital breast tomosynthesis (DBT) has already demonstrated greater sensitivity in the diagnosis of breast pathology and effectiveness in identifying early breast cancers. In addition to being a more sensitive screening tool, other studies indicate DBT has a lower call-back rate when compared with traditional DM. This study compares call-back rates between these two screening tools. A single institution, retrospective review was conducted of almost 20,000 patient records who underwent digital mammography or DBTin the years 2016 to 2018. These charts were analyzed for documentation of imaging type, Breast Imaging Reporting and Data System 0 status, call-back status, and type of further imaging that was required. Charts for 19,863 patients were reviewed, 17,899 digital mammography examinations were conducted compared with 11,331 DBT examinations resulting in 1,066 and 689 Breast Imaging Reporting and Data System 0 studies, respectively. Of the DM call-backs, 82.08 per cent were recommended for additional radiographic imaging and 17.82 per cent for ultrasound imaging. In the DBT group, only 39.77 per cent of callbacks were recommended for additional radiographic imaging and 60.09 per cent for ultrasound imaging. Our data suggest that DBT results in less call-back for additional mammographic images as compared with digital mammography. DBT may offer benefits over DM, including less imaging before biopsy, less time before biopsy, quicker diagnosis, and improved patient satisfaction.

Antecedents: A Half-Century of Imaging the Breast

2019 ◽  
Vol 1 (1) ◽  
pp. 2-8
Author(s):  
Daniel B Kopans
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance ◽  
Breast Imaging ◽  
Death Rate ◽  
Digital Breast Tomosynthesis ◽  
Breast Cancers ◽  
Breast Tomosynthesis ◽  
Half Century ◽  
X Ray ◽  
Detect Breast Cancer

Abstract The field of Breast Imaging evolved because a fairly small number of dedicated individuals realized the lifesaving potential of detecting breast cancer earlier. They persevered despite persistent efforts to curtail screening. From the first attempts to produce X-ray images of the breast to magnetic resonance and digital breast tomosynthesis, investigators have worked continuously to develop better ways to detect breast cancer at a time when cure is possible, while working continuously to preserve access for women to screening. Consequently, the death rate from breast cancer has declined by more than 40%. Therapy has improved, but therapy saves lives when breast cancers are treated early.

The Diagnostic Performance of Wide-Angle Digital Breast Tomosynthesis in Comparison to Hand-Held 2D Ultrasound in the Evaluation of Probably Benign & Malignant Lesions in Dense Breast Parenchyma

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 33-33
Author(s):  
I. Ewais ◽  
A. Awis ◽  
Y. Fahim ◽  
S. Khodair ◽  
H. Gewefel
Keyword(s):  
Diagnostic Performance ◽  
Digital Breast Tomosynthesis ◽  
Dense Breast ◽  
Architectural Distortion ◽  
Wide Angle ◽  
Benign Lesions ◽  
Breast Tomosynthesis ◽  
Dense Breasts ◽  
Negative Results ◽  
Malignant Lesions

Background: Imaging of dense breast represents a diagnostic challenge for interpreting radiologists. Tomosynthesis and ultrasound are used as additional imaging tools to compensate the lower sensitivity of 2D mammography when examining a dense breast. This study compares the diagnostic performance of 50° wide-angle digital breast tomosynthesis (wide-angle DBT) to hand-held breast ultrasound (HHUS) in the evaluation of probably benign and malignant breast lesions in dense breast. Patients and Methods: A retrospective review of 131 women with dense breasts (ACR C and D) was conducted during a 12-months period (October 2018 -October 2019). Out of the 131 women; 40 cases (30.5%) were reported to have 64 probably benign and malignant lesions (BI-RADS 3, 4 and 5) detected by combined wide-angle DBT and HHUS. Patients with negative results (BI-RADS 1) or typically benign lesions (BI-RADS 2) were excluded from this study. Median age for the included 40 cases=46.8 years (range =30-67). Women above the age of 40 (n=35, 87%) were examined with combined 2D mammogram + wide-angle DBT and ultrasound. Women below 40 (n=5, 13%) were initially examined by ultrasound and obtained complementary wide-angle DBT mammography based on clinical necessity. Separate BI-RADS were given for each modality and independently correlated with histopathological results for BI-RADS 4 and 5, or routine follow up images for BI-RADS 3. Results: Among the 64 lesions; 10 (15.6%) were pathologically proven malignant in 5 cases (two cases were presenting with multi-focal disease), and 54 (84.4%) benign lesions pathologically proven or followed up in 35 patients. Sensitivity was 100% for wide-angle DBT (10/10) and 80% for ultrasound (8/10). Specificity and positive predictive value for ultrasound was 94.4% (51/54) and 72.7% (8/11), respectively. For wide-angle DBT, specificity was 90.7% (49/54) and positive predictive value was 66.7% (10/15). Despite the high sensitivity, in our study, DBT showed equal diagnostic accuracy to that of breast ultrasound (92.2%, 59/64). Both modalities were not similar in depicting malignant lesions; two more lesions were initially identified at wide-angle DBT images presented as <1cm area of architectural distortion (p=0.07). Other two diagnostic cases presented with acute inflammatory symptoms; they showed architectural distortion in DBT, which were false-positives for the later, yet, ultrasound showed mastitis and abscess formation. Ultrasound significantly identified more benign lesions than DBT mammography (p=0.001). Conclusion: Wide-angle DBT and HHUS are indispensable in identifying probably benign and malignant lesions in dense breasts. Our study showed the role of Wide-angle DBT in detecting small (<1 cm) malignant lesions presenting as architectural distortion. However, the radiologists experience with DBT and the significant clinical information added by ultrasound may impact the diagnostic performance. Therefore, supplemental HHUS to wide-angle DBT will increase accuracy and true negative results for a lower benign biopsy rate.

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