Comparison of diagnostic accuracy of digital breast tomosynthesis, digital mammography, and ultrasonography for the non-calcified ductal carcinoma in situ of the breast

Abstract

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT), digital mammography (DM), and ultrasonography (US) for the non-calcified ductal carcinoma in situ (DCIS) of the breast. Methods To retrospectively analyze the imaging and clinical data of ductal carcinoma in situ which was confirmed by surgical pathology and displayed as non-calcified lesions in mammography in 110 patients. DBT, DM and US were performed in all the 110 cases. The breast imaging report and data system (BI-RADS) classification and breast density classification were evaluated using the 5th edition of BI-RADS. In our study, BI-RADS 4B, 4C, and 5 were regarded to be in agreement with the pathologic findings, BI-RADS 1, 2, 3, and 4A were considered to be negative. BI-RADS c and d were classified as dense breasts, BI-RADS a and b were classified as fatty breasts. The imaging findings of the non-calcified ductal carcinoma in situ were evaluated. The differences in the detection rate and the diagnostic accuracy among the DBT, DM and US in all cases and in different breast density were compared using χ2 test. Results The detection rates of DBT, DM, and US for non-calcified DCIS in all cases were 84.5% (93/110), 70.9% (78/110), 95.5%(105/110). Pairwise comparisons among the three techniques showed statistically significant difference (P 0.05). By DBT and DM, most cases of non-calcified DCIS presented as a mass lesion with an irregular shape, indistinct margin, and isodense composition. Conclusion US is more advantageous to the detection of the non-calcified DCIS and the non-calcified DCIS in the dense breast. Key words: Breast neoplasms; Mammography; Comparative study; Tomosynthesis