Detection of noncalcified breast cancer in patients with extremely dense breasts using digital breast tomosynthesis compared with full-field digital mammography

Abstract

Breast density-tailored screening for breast cancer in females is of great interest. 1 Breast density is a predictor of breast cancer; it reduces the sensitivity of mammography, leading to an increased risk of interval cancer in the screening population. 2,3 Several breast imaging modalities have been used as adjuncts to screening mammography in females with dense breasts, including ultrasound (US; handheld or automated), MRI, and the more recently applied digital breast tomosynthesis (DBT). DBT is an emerging technique that allows the breast to be viewed quasi-three-dimensionally, which reduces superimposition of the breast tissue. 4,5 Previous studies showed that DBT improved the accuracy of full-field digital mammography (FFDM) in screening across all breast densities by reducing the recall rates and increasing the cancer detection rates. 6-10 In addition, a recent study including females with dense breasts reported that the addition of DBT increased the sensitivity of FFDM. 11-13 To date, the effect of breast density on the diagnostic performance of DBT was evaluated based on percentage-based classification. Breast density assessed using mammography, reflects the breast composition. High breast density can comprise various breast compositions. The tumour located in the dense breast with small amount of interposed fat tissue that overlaps individual sections may result in mammographically occult cancer and even with the use of DBT. 14 Moreover, in case of the occurrence of small tumour without noticeable calcification,

<p>The role of digital breast tomosynthesis in breast cancer screening: a manufacturer- and metrics-specific analysis</p>

“…Results showed no improvement in observer performance with the addition of DBT. Later studies concluded that observer performance increases with the addition of DBT to DM when using more advanced Hologic models 13,16,35–43. Specifically in the detection and characterization of invasive lobular cancers, DM&DBT significantly increases sensitivity compared to DM alone 44…”

“…It should be noted that the three latter studies have in common a relatively small number of participants (100–200 women). Specifically, for “extremely dense breasts” Yi et al35 found a non-statistically significant difference in the specificity of the systems.…”

“…As shown by Kim et al,41 prior mammograms can affect the specificity of the imaging systems. In addition, as discussed above, patient specific background might affect the optimum usage of an imaging system and this has been recently assessed in a few studies 25,35. For example, the risk of cancer for a woman, which might be relevant to factors like history, age and breast density, might change the frequency and number of times a patient is screened and the implementation by which she is screened.…”

Comparative study between contrast-enhanced mammography, tomosynthesis, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma

“…Digital breast tomosynthesis (DBT) provides quasi-3D imaging of the breast, so it reduces the superimposition of breast tissue and improves cancer detection. Previous studies showed that DBT improved the sensitivity, specificity, and accuracy of full-field digital mammography by reducing the recall rates and increasing the cancer detection rates [7,8].…”

Prevalencia de tejido mamario denso en una población en la ciudad de Bucaramanga, Colombia

“…Sin embargo, la sensibilidad global de este método, que va del 75 al 85%, puede llegar a disminuir hasta un 30-50% en mujeres con senos densos (9). Por lo tanto, se ha evaluado la realización de técnicas complementarias como la ecografía, la resonancia magnética y la tomosíntesis (10).…”