DBT-galactography: a promising tool for improving the diagnostic workup of nipple discharge

Moschetta, Marco; Ruvo, Vincenzo De; Drago, Angelica; Troiano, Nicoletta; Paolicelli, Simona; Rubini, Giuseppe; Ianora, Amato Antonio Stabile; Telegrafo, Michele

doi:10.1186/s41747-020-00170-5

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…In 49 patients with pathological nipple discharge, surgical pathological confirmation found that the DBT-galactography had higher sensitivity, specificity, PPV, and NPV than FFDM-galactography. This is consistent with the findings of Moschetta et al [18] that DBT-galactography is more sensitive, and that the application of DBT-galactography in catheter increases the confidence of diagnosis.…”

Section: Discussionsupporting

confidence: 92%

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Evaluation of Breast Galactography Using Digital Breast Tomosynthesis: A Clinical Exploratory Study

et al. 2021

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Objectives: To compare the application value of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in breast galactography. Materials and Methods: A total of 128 patients with pathological nipple discharge (PND) were selected to undergo galactography. DBT and FFDM were performed for each patient after injecting the contrast agent; the radiation dose of DBT and FFDM was calculated, and the image quality was evaluated in consensus by two senior breast radiologists. Histopathologic data were found in 49 of the 128 patients. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for both FFDM- and DBT-galactography were calculated using histopathologic results as a reference standard. Data were presented as percentages along with their 95% confidence intervals (CI). Results: The average age of the 128 patients was 46.53 years. The average glandular dose (AGD) of DBT-galactography was slightly higher than that of FFDM-galactography (p < 0.001). DBT-galactography was 30.7% higher than FFDM-galactography in CC view, while DBT-galactography increased by 21.7% compared with FFDM-galactography in ML view. Regarding catheter anatomic distortion, structure detail, and overall image quality groups, DBT scores were higher than FFDM scores, and the differences were significant for all measures (p < 0.05). In 49 patients with pathological nipple discharge, we found that the DBT-galactography had higher sensitivity, specificity, PPV, and NPV (93.3%, 75%, 97.7%, and 50%, respectively) than FFDM-galactography (91.1%, 50%, 95.3%, and 33.3%, respectively). Conclusions: Compared to FFDM-galactography, within the acceptable radiation dose range, DBT-galactography increases the sensitivity and specificity of lesion detection by improving the image quality, providing more confidence for the diagnosis of clinical ductal lesions.

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Section: Discussionsupporting

confidence: 92%

“…In recent studies, Jong Yoon Lee et al [17] applied DBT in galactography and retrospectively analyzed the application of DBT and SM 2D in catheterization in 35 cases. Marco Moschetta et al [18] compared the diagnostic performance of DBT-galactography with that of FFD-galactography [18].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Breast Galactography Using Digital Breast Tomosynthesis: A Clinical Exploratory Study

et al. 2021

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“…Additionally, mammary ductoscopy is a technology that allows for the direct visualization and biopsy examination of the mammary ductal abnormalities [26,27]. Furthermore, recent studies [28,29] have reported that digital breast tomosynthesis-GL may become an important diagnostic step for managing PND.…”

Section: Discussionmentioning

confidence: 99%

Galactography Combined with Sonogalactography for Improving the Evaluation of Pathological Nipple Discharge

et al. 2020

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Diagnosing patients with pathological nipple discharge (PND) is controversial, and therefore a standardized diagnosis algorithm is needed. The objective of this study was to investigate the usefulness of galactography (GL) combined with sonogalactography (SGL) for the evaluation of PND patients. A retrospective study was conducted of 51 patients with PND who were evaluated with GL and SGL. The findings from the galactograms of the patients in this study were assigned to different categories of the Galactogram Image Classification System. Additionally, the sensitivity, specificity, and the positive predictive values and negative predictive values of the GL and SGL tests were calculated, considering the gold standard of pathology diagnosis. The results obtained show that GL combined with SGL improved the diagnostic efficiency of ductal lesions, especially for borderline and malignant lesions. Papilloma was diagnosed in 19 cases, and ductal carcinoma in situ in 8 patients. Conclusions: To the best of our knowledge, this is the first study in which the combination of GL and SGL improves the diagnostic efficiency of ductal lesions of patients with PND. A diagnosis algorithm is recommended for women with PND.

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“…6,7 There are several studies evaluating digital breast tomosynthesis (DBT) galactography (ductography) for nipple discharge workup, comparing it with traditional 2D digital mammography ductography, but there were no reports published on the diagnostic performance of DBT in the evaluation of nipple discharge. 8,9 The aim of this study is to assess the value of DBT in evaluating patients with nipple discharge and to compare it with MMG, US, and MRI.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of digital breast tomosynthesis in female patients with nipple discharge

Ostojić

Grbanovic

Tonklin³

et al. 2022

Cancer Reports

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Background Nipple discharge is one of the most common symptoms related to the breast, but it is a presenting feature of breast cancer in 5%–12% of women. Aims The purpose of this study was to determine the diagnostic performance of digital breast tomosynthesis (DBT) in the evaluation of patients with nipple discharge and to compare it with mammography (MMG), ultrasound (US), and magnetic resonance imaging (MRI). Methods and Results This retrospective study included 53 patients with nipple discharge. All patients underwent DBT, and results were compared to MMG, breast US, and MRI. Radiological findings for each method were categorized according to BI‐RADS classification: categories 1–2 were considered negative and categories 3–5 positive. If a tissue specimen was obtained, the final diagnosis was established based on the results of histopathological analysis; otherwise, a clinical follow‐up was required for at least 2 years to confirm benign radiological findings. Measures of diagnostic accuracy of DBT, MMG, US, and MRI were calculated and compared. Results Final histopathological analysis revealed six malignant breast lesions, all of which were detected in patients with pathologic nipple discharge. DBT and MRI exhibited high sensitivity (100%) and high negative predictive value (100%) for the detection of breast cancer in patients with nipple discharge. DBT showed higher specificity compared to MRI (82.9% vs. 61.9%). Sensitivity and specificity of MMG were 83.3% and 76.6%, respectively. Breast US was determined to have a sensitivity of 66.7% and specificity of 57.5%. Conclusion DBT exhibited higher specificity than MRI at the same level of sensitivity and negative predictive value. Therefore, the use of DBT should be considered as an alternative to MRI in the assessment of patients with nipple discharge.

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DBT-galactography: a promising tool for improving the diagnostic workup of nipple discharge

Cited by 6 publications

References 21 publications

Evaluation of Breast Galactography Using Digital Breast Tomosynthesis: A Clinical Exploratory Study

Evaluation of Breast Galactography Using Digital Breast Tomosynthesis: A Clinical Exploratory Study

Galactography Combined with Sonogalactography for Improving the Evaluation of Pathological Nipple Discharge

Diagnostic performance of digital breast tomosynthesis in female patients with nipple discharge

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