Three-dimensional tomosynthesis versus two-dimensional mammography in detection and characterization of different breast lesions

Samia Aboelnour Abdeltwab Abdelattef,Fatten Mohamed Mahmoud,Suzan Farouk Ibrahim,Wafaa Raft Abdelhamid

doi:10.1186/s43055-021-00648-1

Abstract

BackgroundBreast cancer is considered the most serious lesion among different breast lesions. Mammography is the corner stone for screening for detection of breast cancer. It has been modified to digital mammography (DM) and then to digital breast tomosynthesis (DBT). Tomosynthesis is an emerging technique for diagnosis and screening of breast lesions.The aim of this study is to interrogate whether the addition of DBT to DM helps in better detection and characterization of different breast lesions.MethodsThis is a prospective study carried on 38 female patients according to our inclusion criteria. All patients were evaluated by using DM alone and thereafter with the addition of DBT to DM. Recall rate was calculated, and the imaging findings of each case were correlated with the final diagnosis and follow-up.ResultsDM identified 32 lesions while DBT with DM identified 37 lesions. On DM alone, 17 lesions were characterized as masses, 5 as focal asymmetry, 2 as architectural distortion, 7 as microcalcification and 1 as macrocalcification. With the addition of DBT, 27 lesions were characterized as masses, 1 as focal asymmetry, 1 as architectural distortion, 7 as microcalcification and 1 as macrocalcification. So, there were better detection and characterization of lesions with the addition of DBT than DM alone. The sensitivity, specificity, AUC, positive and negative predictive values were significantly higher with the addition of DBT to DM (100%, 90.5%, 0.952, 90% and 100%, respectively) than with DM (77.8%, 80.9%, 0.794, 77.8% and 80.9%, respectively) for all breast lesions.ConclusionsThe addition of DBT to DM helps in better detection and characterization of different breast lesions. This leads to early detection of breast cancer, improvement of the performance of radiologists and saving time by reduction of recall rate.

Highlights

Breast cancer is considered the most serious lesion among different breast lesions
The sensitivity, specificity, area under the Receiver operator characteristic (ROC) curve (AUC), positive and negative predictive values were significantly higher with the addition of digital breast tomosynthesis (DBT) to digital mammography (DM) (100%, 90.5%, 0.952, 90% and 100%, respectively) than with DM (77.8%, 80.9%, 0.794, 77.8% and 80.9%, respectively) for all breast lesions
The addition of DBT to DM helps in better detection and characterization of different breast lesions

Summary

Introduction

Breast cancer is considered the most serious lesion among different breast lesions. Mammography is the corner stone for screening for detection of breast cancer. Tomosynthesis is an emerging technique for diagnosis and screening of breast lesions. The aim of this study is to interrogate whether the addition of DBT to DM helps in better detection and characterization of different breast lesions. Much concern is given to malignant lesions of the breast because breast cancer is the most common malignancy in women; benign lesions of the breast are far more frequent than malignant ones [6]. Enhancing breast cancer outcome and survival by early detection remains the foundation of breast cancer regulations [1] (Fig. 1). In the 1970s, mammography gained widespread acceptance as a breast screening tool for cancer detection. Technological advancements have driven the evolution from analog film mammography to full-field digital mammography (FFDM) and DBT [27] (Fig. 2)

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