Significance and Application of Digital Breast Tomosynthesis for the BI-RADS Classification of Breast Cancer

Cai, Sanjun; Yan, Jianxiang; Chen, Qingshi; Huang, Meiling; Cai, Donglu

doi:10.7314/apjcp.2015.16.9.4109

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…When comparing the ROC areas, it was found that DBT is significantly superior to DM in breast cancer diagnosis (AUC = 0.883 vs 0.619; p < 0.0001), and the BI-RADS with combined DM and DBT was significantly superior to BI-RADS with DM or BI-RADS with DBT alone (AUC: 0.971; p < 0.0001). Similarly, Cai et al [33] analyzed 79 cases with pathologic results by using ROC curve and showed that the AUC of the combined DM and DBT was greater than that of DM alone (0.914 vs. 0.805). Also, Thomassin et al [34] calculated AUC by averaging the ROC from four readers; the mean AUC for BI-RADS with combined DM and DBT was higher than that calculated for BI-RADS with DM alone (0.809 vs. 0.685; p < 0.01).…”

Section: Discussionmentioning

confidence: 99%

The added value of digital breast tomosynthesis in improving diagnostic performance of BI-RADS categorization of mammographically indeterminate breast lesions

et al. 2020

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Background: Mammographic findings are seen more clearly in tomographic images with consequent improvement of Breast Imaging Reporting and Data System (BI-RADS) in categorization of indeterminate breast lesions. This study aimed to evaluate the added value of digital breast tomosynthesis (DBT) to BI-RADS classification in categorization of indeterminate breast lesions after digital mammography (DM) as an initial approach. Methods and results: We prospectively evaluated 296 women with BI-RADS indeterminate breast lesions (BI-RADS 0, 3, and 4) by DM between January 2018 and October 2019. All patients underwent DBT. Two radiologists evaluated lesions and assigned a BI-RADS category to each lesion according to BI-RADS lexicon 2013 classification using DM, DBT, and combined DM and DBT. The results were compared in terms of main radiological features, diagnostic performance, and BI-RADS classification using histopathology as the reference standard. A total of 355 lesions were detected on DBT and 318 lesions on DM. Thirty-seven lesions were detected by DBT and not seen by DM. The final diagnoses of 355 lesions were 58.3% benign and 41.7% malignant. In comparison to DM, DBT produced 31.5% upgrading and 35.2% downgrading of BI-RADS scoring of breast lesions. DBT reduced number of BI-RADS 3 and 4, compared to DM. All upgraded BI-RADS 4 were malignant. The combination of DBT and DM significantly increased the performance of BI-RADS in the diagnosis of indeterminate breast lesions versus DM or DBT alone (p < 0.001). Conclusion: Adding DBT to BI-RADS improves its diagnostic performance in detection and characterization of mammography indeterminate breast lesions.

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Section: Discussionmentioning

confidence: 99%

The added value of digital breast tomosynthesis in improving diagnostic performance of BI-RADS categorization of mammographically indeterminate breast lesions

et al. 2020

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“…However, there are a lack of non-invasive methods for the molecular classification of breast cancer. On the basis of a previous study that indicated that the sensitivity of breast cancer diagnosis increases from 60% using traditional digital mammography to 82.9% using DBT (16), the present study investigated further the associations between breast cancer molecular subtypes and DBT imaging characteristics, including tumor margin, surrounding bright ring of tumor, vascular images and calcification foci, lymph node size and associations with surrounding glandular tissue. The aim of the present study was to demonstrate that DBT may serve as a clinical diagnostic tool for diagnosing molecular subtypes of breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study revealed that DBT has important influence and significance in the classification of breast imaging-reporting and data system (BI-RADS). The diagnostic sensitivity increased from 60% with traditional digital mammography to 82.9% with DBT and the specificity of the two techniques used together was 93.2% (16). Primary indicators for BI-RADS classification include tumor margin, surrounding bright ring of tumor, vascular images and calcification foci, lymph node size, and associations with surrounding glandular tissue (17–19), and identification of these indicators is improved in a tomographic image (20).…”

Section: Introductionmentioning

confidence: 99%

Association between digital breast tomosynthesis and molecular subtypes of breast cancer

et al. 2019

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In recent years, with increasing prevalence, particularly in young patients, breast cancer is considered to be one of the most common malignancies. The aim of the present study was to evaluate the clinical value of digital breast tomosynthesis (DBT) in diagnosing molecular subtypes of breast cancer. The present study retrospectively analyzed 134 cases of breast cancer with data regarding surgery, complete pathology and immunohistochemistry, which were collected at The Second Clinical College of Fujian Medical University (Quanzhou, China) between May 2013 and October 2014. The patients were divided into the four following molecular subtypes: Luminal A, luminal B, triple-negative and human epidermal growth factor receptor 2 (HER-2) overexpression, according to the expression of estrogen receptor, progesterone hormone receptor, HER-2 and Ki67. The association between clinical characteristics of each molecular subtype and characteristics of DBT were assessed. Calcification scores and lymph node size were the indicators that exhibited a significant difference following comparison between the four molecular subtypes. The subgroup analysis based on tumor size, calcification scores and lymph node size identified a significant difference in the distribution between patients with breast cancer with lymph node size of ≥1.5 and <1.5 cm. The analysis also revealed that the molecular subtypes of breast cancer were significantly associated with variables of calcification scores and lymph node size. In conclusion, the diagnostic imaging features, including calcification score and lymph node size, determined using DBT could be used as assistant diagnostic markers of breast cancer molecular subtypes.

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“…However, radiologists can only recognize the calcifications with a diameter of >0.5 mm, and many micro-calcifications are missed. For instance, the occurrence rate of calcifications in screening X-rays is >40%, while the occurrence rate of calcifications in pathological sections is >70% (11,12). …”

Section: Discussionmentioning

confidence: 99%

The use of sequential X-ray, CT and MRI in the preoperative evaluation of breast-conserving surgery

Zhang

Tan

Gao

et al. 2016

Experimental and Therapeutic Medicine

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The aim of the study was to investigate the value of sequential application of molybdenum target X-ray, multi-slice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) in the preoperative evaluation of breast-conserving surgeries. In total, 76 patients with indications for breast-conserving surgery due to complicated breast cancer participated in the study and were assigned to either control or observation group (n=38 per group). The patients in the control group were evaluated with two sets of random combinations of molybdenum target X-ray, MSCT or MRI with ultrasound inspection, whereas the patients in the observation group were evaluated by sequential inspection methods of molybdenum target X-ray, MSCT and MRI. A comparison of surgery outcomes, incidence of complications, rate of positive surgical margins, and recurrence and survival rates in the groups during a follow-up period of 24 months was made. Comparisons of the preoperative evaluation results for tumor number, average maximum diameter, number of lymphatic metastatic groups and number of metastatic lymph nodes in the observation group showed the numbers to be significantly higher than those in the control group (P<0.05). Conversely, the comparisons of age, tumor distribution and T-staging yielded no significant differences, validating the analysis. The percentage of successful breast-conserving surgeries in the observation group was significantly higher than that in the control group, while the incidence of complications in the observation group was lower (P<0.05). The rate of positive surgical margins and the recurrence rate of cancer in the observation group were lower than those in the control group, and the survival rate in the observation group was higher, with differences having statistical significance (P<0.05). In conclusion, the sequential application of molybdenum target X-ray, MSCT and MRI during the preoperative evaluation for breast-conserving surgery positively affects the success rate of the procedure improving the diagnostic accuracy and therapeutic effects.

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Significance and Application of Digital Breast Tomosynthesis for the BI-RADS Classification of Breast Cancer

Cited by 8 publications

References 24 publications

The added value of digital breast tomosynthesis in improving diagnostic performance of BI-RADS categorization of mammographically indeterminate breast lesions

The added value of digital breast tomosynthesis in improving diagnostic performance of BI-RADS categorization of mammographically indeterminate breast lesions

Association between digital breast tomosynthesis and molecular subtypes of breast cancer

The use of sequential X-ray, CT and MRI in the preoperative evaluation of breast-conserving surgery

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