Abstract

Objective: To compare the accuracy of standard supplementary views and GE digital breast tomosynthesis (DBT) for assessment of soft-tissue mammographic abnormalities. Methods: Women recalled for further assessment of soft-tissue abnormalities were recruited and received standard supplementary views (typically spot compression views) and two-view GE DBT. The added value of DBT in the assessment process was determined by analysing data collected prospectively by radiologists working up the cases. Following anonymization of cases, there was also a retrospective multireader review. The readers first read bilateral standard two-view digital mammography (DM) together with the supplementary mammographic views and gave a combined score for suspicion of malignancy on a five-point scale. The same readers then read bilateral standard two-view DM together with two-view DBT. Pathology data were obtained. Differences were assessed using receiver operating characteristic analysis. Results: The study population was 342 lesions in 322 patients. The final diagnosis was malignant in 113 cases (33%) and benign/normal in 229 cases (67%). In the prospective analysis, the performance of two-view DM plus DBT was at least equivalent to the performance of two-view DM and standard mammographic supplementary views—the area under the curve (AUC) was 0.946 and 0.922, respectively, which did not reach statistical significance. Similar results were obtained for the retrospective review—AUC was 0.900 (DBT) and 0.873 (supplementary views), which did not reach statistical significance. Conclusion: The accuracy of GE DBT in the assessment of screen detected soft-tissue abnormalities is equivalent to the use of standard supplementary mammographic views. Advances in knowledge: The vast majority of evidence relating to the use of DBT has been gathered from research using Hologic equipment. This study provides evidence for the use of the commercially available GE DBT system demonstrating that it is at least equivalent to supplementary mammographic views in the assessment of soft-tissue screen-detected abnormalities.

Highlights

  • The aim was to compare the accuracy of standard supplementary views and GE digital breast tomosynthesis (DBT) for assessment of soft tissue mammographic abnormalities

  • The measured parameter is the volume averaged speed of sound (VASS) [1,2]. It improves on mammography by measuring density at each voxel and holds promise as a cheap, patient-acceptable, non-ionising radiation method to evaluate density

  • This study was to evaluate the technique of Ultrasound tomography (UST) and compare VASS with percentage water density from non-contrast magnetic resonance imaging (MRI)

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Summary

Introduction

The aim was to compare the accuracy of standard supplementary views and GE digital breast tomosynthesis (DBT) for assessment of soft tissue mammographic abnormalities. Methods: Prospective audit of data collated at the time of the microbubbles procedure together with multidisciplinary meeting records identified relevant screening and symptomatic patients with primary breast cancer treatment including axillary node surgery between 1 July 2014 and 1 July 2015. Breast MRI can be performed in the preoperative workup of patients with biopsy-proven breast cancer to size lesions, if there is discrepancy regarding the extent of disease from clinical, mammography or ultrasound assessment, and to identify multicentric or multifocal disease. Conclusion: MRI is more sensitive than the other three imaging modalities combined in accurately identifying multifocal breast cancer; DBT is still a useful adjunct in the evaluation of multifocal disease. Retrospective review of 399 patients who underwent biopsy for breast microcalcification during screening assessment from April 2012 to March 2013 was used to evaluate the performance and cost-effectiveness of both methods. Radiologist time may be better directed towards meeting the symptomatic breast 2-week wait standard

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