Background: Breast 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. Results: A 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. Conclusion: 3D DBT significantly reduced the need for additional mammographic views and frequent follow-up studies as it gave better characterization for all BIRADS 3 lesions.
Background Mammography plays a great role in reducing breast cancer mortality as it is the standard method of breast imaging and screening. But the accuracy of mammography performance reduces in cancer detection in women with dense breast due to the summation of images and overlapping of breast tissue. ABUS and tomosynthesis both recently help to detect breast cancer in dense breasted women. This prospective study was done in the female imaging unit and approved by its research and ethical committee; all the patients did an informed consent during the period from October 2018 to March 2019. The study was conducted on 38 patients with 38 lesions subjected to digital mammography, tomosynthesis and automated breast ultrasound (ABUS), who all had dense breast in mammography. Results Automated breast ultrasound (ABUS) showed 100% in all sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) as well as accuracy, while the digital mammography tomosynthesis showed 100% in specificity, 87.5% in sensitivity, 100% in PPV, 82.4% in NPV and 92.1% accuracy. Conclusion Automated breast ultrasound (ABUS) together with tomosynthesis makes a revolution in breast screening and detecting cancer in women with dense breasts.
1523 Background: According to the World Health Organization,the number of breast cancercases in developing countries will increase dramatically by the year 2050. Egypt is likely to see an increase in this disease burden unless effective programs for early detection and control are implemented. Many women, especially those who are medically underserved, still do not understand the importance of regular mammograms, or how and where to get one. Methods: Four mobile mammography vans were launched in October 2007, to screen women over 45 years old in the underserved areas of Cairo. Each van was equipped with a full field digital mammography (FFDM) machine, dedicated computer system linked to the National Breast Screening Center via video SAT & ADSL, sphygmomanometer, blood glucose measuring kit, and spring scale and meter to measure weight and height. Based on positive findings, patients were directed to Cairo University Hospital to receive appropriate treatment. Mobile units continued to operate through October, 2008. Results: From October 2007 through October 2008, 11,414 women were screened for breast cancer, hypertension, diabetes, and obesity. Two hundred forty four (2.13%) women were radiologically positive for cancer; of these, only 112 (45.9%) women agreed to be recalled for assessment; of these, 49.1% were confirmed to be true positive with BI-RADS 4,5 (61% cases were mass, with 27.9 % 1–2 cm in size; 16.4% cases were microcalcifications alone; multicentricity in 6.6 %; bilaterality in 2.5% of cases). 36.6% were false positive, and 14.2% are under further investigation. Conclusions: Although Cairo is the most developed city in Egypt, there is lack of breast cancer awareness, especially in the underserved areas. Breast cancer is now a priority for the Ministry of Health, with four more vans and 10 fixed FFDM units to be implemented during the next year. A 5-year plan has been established to cover all 29 Egyptian Governorates. No significant financial relationships to disclose.
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