Asymmetries: Comparison Between Full Field Digital Mammography and Digital Breast Tomosyntesis

Abstract

INTRODUCTION: Breast Tomosynthesis (DBT) is a procedure developed from digital mammography unit to enable the acquisition of a three-dimensional (3D) volume of thinsection data. The slice examination of breasts can reduce or even eliminate tissue overlap. The purpose of this study was to evaluate if breast tomosynthesis can help to differentiate the assymetries from the overlapping tissues. MATERIALS AND METHODS: A total of 48 cases of asymmetries were referred to perform stereotactic guided core needle biopsy or vacuum assisted biopsy. Each case was analyzed with full field digital mammography(FFDM) and with digital breast tomosynthesis (DBT) previously to the procedure. The study included 47 women (age range 34-78 years, mean age 44, 3 years;) and all the lesions were sampled. The histopathologic results were compared with those obtained with FFDM and DBT. RESULTS: of the 48 cases of asymmetries, 19 (39, 58%) did not change with DBT and 27 (60, 41%) attenuated or disappeared. Among the 19 lesions, the stereotactic guided biopsy diagnosed 8 cases of breast cancer (4 invasive ductal carcinoma, 3 invasive lobular carcinoma, 1 ductal carcinoma in situ), 1 of lobular neoplasia, 1 atypical ductal hyperplasia, 6 of fibroadenoma and 3 cases of normal breast tissue. There were no cases of breast cancer or atypical hyperplasia in those images that attenuated or disappeared with DBT. In this study the biopsy could be avoided in 60, 41% of the cases of asymmetries with the performance of the DBT. DISCUSSION: These results indicate that DBT can be useful in the differentiation between the asymmetries and the overlapping tissues, allowing a decrease in the number of unnecessary biopsies in these cases.