Study of role of digital breast tomosynthesis over digital mammography in the assessment of BIRADS 3 breast lesions

Engy A Ali,Lamiaa Adel

doi:10.1186/s43055-019-0052-5

Abstract

BackgroundBreast cancer is the most common malignancy in women and thus, screening has become an important health issue. Although mammography remains the standard of care for breast cancer screening and diagnosis (with biopsy), tomosynthesis (3D DBT) allows the separation of overlapping structures seen on 2D mammography and thus enables better depiction of masses or asymmetries.ResultsA prospective study for mammographic cases referred to our radiology unit included 60 lesions detected in 59 patients that were performed during the period from January 2016 to September 2017. Patients’ ages ranged from 26 to 72 years with mean age 51 ± 12 SD. Sixty percent of breast imaging-reporting and data system (BIRADS) 3 lesions detected by 2D digital mammography (36/60) changed their category after 3D DBT, 40% (24/60) digital mammography noticed lesions did not change their BIRADS after 3D DBT. Twenty-nine BIRADS 3 lesions out of the 60 were downgraded to BIRADS 1and 2, while 7 BIRADS 3 lesions out of the 60 were upgraded to BIRADS 4 and 5 which were all biopsied. Six out of the 7 lesions were pathologically proven ducal carcinoma and 1 out of 7 pathologically proven to be atypical ductal hyperplasia.Conclusion3D DBT significantly reduced the need for additional mammographic views and frequent follow-up studies as it gave better characterization for all BIRADS 3 lesions.

Highlights

Breast cancer is the most common malignancy in women and screening has become an important health issue
Digital breast tomosynthesis (DBT) is a new imaging modality for improving the detection of breast cancer as it provided better detection of the abnormalities especially in females with dense breast and diagnosis of benign lesions resulted in reduction of the recalled cases and negative biopsies as well as assessing efficacy of therapy [4], as well as it enabled visualization of cancers not visualized by conventional mammography [5]
breast imaging-reporting and data system (BIRADS) classification Sixty percent of BIRADS 3 lesions detected by 2D digital mammography (36/60) changed their category after 3D digital breast tomosynthesis (3D DBT) and 40% (24/60) of digital mammography noticed lesions did not change after 3D DBT

Summary

Introduction

Breast cancer is the most common malignancy in women and screening has become an important health issue. Mammography remains the standard of care for breast cancer screening and diagnosis (with biopsy), tomosynthesis (3D DBT) allows the separation of overlapping structures seen on 2D mammography and enables better depiction of masses or asymmetries. Mammography is still the first breast imaging investigation despite its well-known limitations. The sensitivity of mammography is significantly reduced by high breast density. Digital breast tomosynthesis (DBT) is a new imaging modality for improving the detection of breast cancer as it provided better detection of the abnormalities especially in females with dense breast and diagnosis of benign lesions resulted in reduction of the recalled cases and negative biopsies as well as assessing efficacy of therapy [4], as well as it enabled visualization of cancers not visualized by conventional mammography [5]

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