Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer.

Dragana Roganovic,Dag Pavic,Sasa Vujnovic,Dragan Stojanov,Dragana Djilas

doi:10.17305/bjbms.2015.616

Abstract

Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities. We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p <0.001), while the difference between breast tomosynthesis and breast MRI was not significant (p=0.20).

Highlights

The only imaging modality that has been proven to significantly reduce breast cancer mortality in age-appropriate asymptomatic women is annual screening mammography
We evaluated imaging features of 60 breast lesions, depicted using three diagnostic modalities: breast magnetic resonance imaging (MRI), digital mammography (DM) and Digital breast tomosynthesis (DBT)
Three lesions were excluded from the study due to inconsistent findings, we compared the results of imaging findings in 57 breast lesions with the histopathology report

Summary

Introduction

The only imaging modality that has been proven to significantly reduce breast cancer mortality in age-appropriate asymptomatic women is annual screening mammography. The sensitivity of mammography can be limited in dense breast tissue, due to the presence of overlapping fibroglandular tissue which reduces conspicuity of abnormalities [2]. Another factor influencing cancer visibility is the tumor growth pattern. Tumors which do not produce a mass are often difficult to detect on mammography. Depending on these two factors, breast density and tumor growth pattern, the false-negative rate of mammography ranges from 8% to 66% in symptomatic women [4]

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