scholarly journals Diagnostic performance of digital breast tomosynthesis for predicting response to neoadjuvant systemic therapy in breast cancer patients: A comparison with magnetic resonance imaging, ultrasound, and full-field digital mammography

2021 ◽  
Vol 10 (12) ◽  
pp. 205846012110637
Author(s):  
Ryusuke Murakami ◽  
Hitomi Tani ◽  
Shinichiro Kumita ◽  
Nachiko Uchiyama

Background The goals of neoadjuvant systemic therapy (NST) are to reduce tumor volume and to provide a prognostic indicator in assessing treatment response. Digital breast tomosynthesis (DBT) was developed and has increased interest in clinical settings due to its higher sensitivity for breast cancer detection compared to full-field digital mammography (FFDM). Purpose To evaluate the accuracy of DBT in assessing response to NST compared to FFDM, ultrasound (US), and magnetic resonance imaging (MRI) in breast cancer patients. Material and Methods In this retrospective study, 95 stages II–III breast cancer patients undergoing NST and subsequent surgeries were enrolled. After NST, the longest diameter of residual tumor measured by DBT, FFDM, US, and MRI was compared with pathology. Agreements and correlations of tumor size were assessed, and the diagnostic performance for predicting pathologic complete response (pCR) was evaluated. Results Mean residual tumor size after NST was 19.9 mm for DBT, 18.7 mm for FFDM, 16.0 mm for US, and 18.4 mm for MRI, compared with 17.9 mm on pathology. DBT and MRI correlated better with pathology than that of FFDM and US. The ICC values were 0.85, 0.87, 0.74, and 0.77, respectively. Twenty-five patients (26.3%) achieved pCR after NST. For predicting pCR, area under the receiver operating characteristic (ROC) curve for DBT, FFDM, US, and MRI were 0.79, 0.66, 0.68, and 0.77, respectively. Conclusion DBT has good correlation with histopathology for measuring residual tumor size after NST. DBT was comparable to MRI in assessing tumor response after completion of NST.

Author(s):  
Rana M. Naeim ◽  
Rania A. Marouf ◽  
Merhan A. Nasr ◽  
Marwa E. Abd El-Rahman

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


2021 ◽  
Vol 74 (4) ◽  
pp. 842-848
Author(s):  
Andrii V. Gurando ◽  
Tetiana M. Babkina ◽  
Iryna M. Dykan ◽  
Tetiana M. Kozarenko ◽  
Viacheslav R. Gurando ◽  
...  

The aim: Comparing sensitivity and specificity of digital breast tomosynthesis and full-field digital mammography in breast cancer detection associated with four different types of asymmetries according to BI-RADS Atlas. Materials and methods: Study included 201 patients with four types of asymmetries according BI-RADS atlas (asymmetry – 81 (40,3%), focal asymmetry – 82 (40,8%), global asymmetry – 36 (17,9%) and developing asymmetry – 2 (1,0%)) who underwent full-field digital mammography, digital breast tomosynthesis and hand-held full breast ultrasound from January 2017 to June 2018. The general rate of breast cancer for the 201 patients with asymmetries was 8 cases (4,0%) (IBC, n=6 (3,0%); DCIS, n=2 (1,0%) other findings associated with asymmetries were non-malignant, n=10 (5,0%) (sclerosing adenosis, n=5 (2,5%); fibroadenomatosis, n=3 (1,5%); simple cyst, n=1 (0,5%); radial scar associated with papilloma, typical ductal hyperplasia and sclerosing adenosis, n=1 (0,5%). Results: Analysis of the results showed that sensitivity of digital breast tomosynthesis was 75.0% [95% CI, 34.91% to 96.81%] and specificity was 94.8% [95% CI, 90.68% to 97.49%] which was superior to full-field digital mammography sensitivity 50.0% [95% CI, 15.70% to 84.30%] and specificity 91.19% [95% CI, 86.27% to 94.78%] for breast cancer detection associated with different types of asymmetries. Conclusions: Using of digital breast tomosynthesis in assessment of breast asymmetries can improve sensitivity and specificity in breast cancer detection and reduce number of unnecessary biopsies and short-interval follow-up examinations.


Sign in / Sign up

Export Citation Format

Share Document