Study of role of digital breast tomosynthesis over digital mammography in the assessment of BIRADS 3 breast lesions

Abstract Background Breast cancer is the most common malignancy in women and thus, screening has become an important health issue. Although mammography remains the standard of care for breast cancer screening and diagnosis (with biopsy), tomosynthesis (3D DBT) allows the separation of overlapping structures seen on 2D mammography and thus enables better depiction of masses or asymmetries. Results A prospective study for mammographic cases referred to our radiology unit included 60 lesions detected in 59 patients that were performed during the period from January 2016 to September 2017. Patients’ ages ranged from 26 to 72 years with mean age 51 ± 12 SD. Sixty percent of breast imaging-reporting and data system (BIRADS) 3 lesions detected by 2D digital mammography (36/60) changed their category after 3D DBT, 40% (24/60) digital mammography noticed lesions did not change their BIRADS after 3D DBT. Twenty-nine BIRADS 3 lesions out of the 60 were downgraded to BIRADS 1and 2, while 7 BIRADS 3 lesions out of the 60 were upgraded to BIRADS 4 and 5 which were all biopsied. Six out of the 7 lesions were pathologically proven ducal carcinoma and 1 out of 7 pathologically proven to be atypical ductal hyperplasia. Conclusion 3D DBT significantly reduced the need for additional mammographic views and frequent follow-up studies as it gave better characterization for all BIRADS 3 lesions.

Download Full-text

Digital Breast Tomosynthesis: Clinical Operations

Journal of Breast Imaging ◽

10.1093/jbi/wbz007 ◽

2019 ◽

Vol 1 (2) ◽

pp. 122-126

Author(s):

Sarah M Friedewald ◽

Sonya Bhole ◽

Lilian Wang ◽

Dipti Gupta

Keyword(s):

Breast Cancer ◽

Cancer Detection ◽

Digital Mammography ◽

Digital Breast Tomosynthesis ◽

Standard Of Care ◽

Breast Tomosynthesis ◽

Mandated Training ◽

Process Understanding ◽

Quality Imaging

Abstract Digital breast tomosynthesis (DBT) is rapidly becoming the standard of care for breast cancer screening. Implementing DBT into practice is relatively straightforward. However, there are important elements of the transition that one must consider to facilitate this process. Understanding the Digital Imaging and Communications in Medicine (DICOM) standard for DBT, as well as how images are displayed, is critical to a successful transition. Standardization of these processes will allow easier transmission of images from facility to facility, and limit the potential for errors in interpretation. Additionally, recent changes in federal regulations will require compliance with mandated training for the radiologist, technologist, and physicist, as well as accreditation for each DBT unit. These regulations aim to ensure high-quality imaging across the country as has been previously seen with standard digital mammography. Synthesized imaging is the most recent improvement for DBT, potentially obviating the need for a simultaneous traditional digital mammogram exposure. Studies have demonstrated near equivalent performance when comparing the combination imaging of DBT and digital mammography versus DBT combined with synthetic imaging. As the quality of the synthetic images continues to improve, it is increasingly likely that it will replace the traditional mammogram. Adherence to DBT-specific parameters will enhance the physician experience and ultimately translate to increased cancer detection and fewer false positive examinations, benefiting all women who are screened for breast cancer.

Download Full-text

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

The American Surgeon ◽

10.1177/000313481908500837 ◽

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.

Download Full-text

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.

Download Full-text

A prospective study comparing digital breast tomosynthesis with digital mammography in surveillance after breast cancer treatment

European Journal of Cancer ◽

10.1016/j.ejca.2016.04.007 ◽

2016 ◽

Vol 61 ◽

pp. 122-127 ◽

Cited By ~ 13

Author(s):

Joseph Sia ◽

Kate Moodie ◽

Mathias Bressel ◽

Eddie Lau ◽

David Gyorki ◽

...

Keyword(s):

Breast Cancer ◽

Prospective Study ◽

Cancer Treatment ◽

Digital Mammography ◽

Digital Breast Tomosynthesis ◽

Breast Cancer Treatment ◽

Breast Tomosynthesis ◽

A Prospective Study

Download Full-text

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

Wiadomości Lekarskie ◽

10.36740/wlek202107121 ◽

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.

Download Full-text