Faculty Opinions recommendation of Comparative estimation of percentage breast tissue density for digital mammography, digital breast tomosynthesis, and magnetic resonance imaging.

Author(s):  
Erin Aiello Bowles
Author(s):  
Janice Hui Ling Goh ◽  
Toh Leong Tan ◽  
Suraya Aziz ◽  
Iqbal Hussain Rizuana

Digital breast tomosynthesis (DBT) is a fairly recent breast imaging technique invented to overcome the challenges of overlapping breast tissue. Ultrasonography (USG) was used as a complementary tool to DBT for the purpose of this study. Nonetheless, breast magnetic resonance imaging (MRI) remains the most sensitive tool to detect breast lesion. The purpose of this study was to evaluate diagnostic performance of DBT, with and without USG, versus breast MRI in correlation to histopathological examination (HPE). This was a retrospective study in a university hospital over a duration of 24 months. Findings were acquired from a formal report and were correlated with HPE. The sensitivity of DBT with or without USG was lower than MRI. However, the accuracy, specificity and PPV were raised with the aid of USG to equivalent or better than MRI. These three modalities showed statistically significant in correlation with HPE (p < 0.005, chi-squared). Generally, DBT alone has lower sensitivity as compared to MRI. However, it is reassuring that DBT + USG could significantly improve diagnostic performance to that comparable to MRI. In conclusion, results of this study are vital to centers which do not have MRI, as complementary ultrasound can accentuate diagnostic performance of DBT.


2021 ◽  
Vol 18 (4) ◽  
Author(s):  
Hongfang Xu ◽  
Wei Zeng ◽  
Zehong Fu ◽  
Qing Cui

Background: Early diagnosis and timely treatment are crucial for breast cancer patients. Objectives: This study aimed to investigate the diagnostic value of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), and magnetic resonance imaging (MRI) for breast cancer. Patients and Methods: This study was performed on 210 patients diagnosed with breast cancer and benign breast lesions (n = 105) by FFDM, DBT, MRI, and pathological examination from January 2019 to December 2020. The patients’ imaging and clinical data were retrospectively analyzed. The lesions were evaluated according to the breast imaging-reporting and data system, with pathological diagnosis as the gold standard. The diagnostic efficiency of the examination methods was analyzed by plotting the receiver operating characteristic (ROC) curves. The DBT and MRI results were finally compared. Results: In 210 patients, 105 benign and 105 malignant lesions were detected. The area under the ROC curve (AUC) of FFDM, DBT, MRI, FFDM + DBT, and FFDM + MRI was 0.734, 0.857, 0.883, 0.865, and 0.924, respectively. Based on the results, the AUC values were significantly higher for DBT, MRI, FFDM + DBT, and FFDM + MRI compared to FFDM (P < 0.05), while similar values were reported for the former methods (P > 0.05). The diagnostic sensitivity of MRI was higher than that of DBT and FFDM; the sensitivity of DBT was higher than that of FFDM; and the specificity and positive predictive value were higher for DBT compared to MRI and FFDM. Conclusion: Compared to FFDM, DBT and FFDM + DBT could significantly improve the diagnostic efficiency of breast cancer; the diagnostic efficiency of these modalities was comparable to that of MRI and FFDM + MRI. The sensitivity of DBT was lower than that of MRI and higher than that of FFDM, while its specificity and positive predictive value were higher than those of MRI. Overall, FFDM + DBT and FFDM + MRI are conducive to early diagnosis.


2015 ◽  
Vol 22 (3) ◽  
pp. 220 ◽  
Author(s):  
C. Kaniklidis

After some decades of contention, one can almost despair and conclude that (paraphrasing) “the mammography debate you will have with you always.” Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete.To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis—also known as three dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patient-accessible levels to facilitate informed decisions.


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