Study of role of digital breast tomosynthesis over digital mammography in the assessment of BIRADS 3 breast lesions

Abstract

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.

The impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings

“…In a similar study conducted by Basha MA et al, [11] concluded that BIRADS with DBT was significantly superior to BIRADS with DM in breast cancer diagnosis (AUC: 0.883 vs. 0.619; p < 0.0001; 95% CI 0.214 to 0.313), and the BI-RADS with combined DM and DBT was significantly superior to BI-RADS with DM alone or BIRADS with DBT alone (AUC: 0.971; p < 0.0001; 95% CI 0.0565 to 0.120) Ali et al [22] concluded that 3D DBT significantly reduced the need for additional mammographic views and as well the frequent follow-up studies as it gave better characterization for all BIRADS 3 lesions and reduced the stress levels in women. And that scrolling the three-dimensional images for a particular view eliminates the tissue overlap seen in two-dimensional images and improves the resolution for a better diagnostic capability.…”

The Impact of Adding Digital Breast Tomosynthesis to BI-RADS Categorization of Mammographically Equivocal Breast Lesions

“…According to a study by Ali et al [ 29 ], 3D DBT limited the need for additional mammographic views and repeated follow-up visits as it enhanced the depiction of all BI-RADS 3 lesions and lowered anxiety in women with suspicious lesions. They also concluded that scrolling 3D images for a specific view reduces the tissue overlap visible in 2D images, resulting in superior resolution and, consequently, greater diagnostic capabilities.…”

A comparative efficacy study of diagnostic digital breast tomosynthesis and digital mammography in BI-RADS 4 breast cancer diagnosis

“…Our study focuses on BI-RADS 4 designated lesions, which have a wide range of probability of malignancy and resultant overbiopy, thus making improved cancer detection highly desirable in this category. The advent of DBT has certainly resulted in the production of better images and better portrayal of massess, asymetries, and other anomalies by facilitating the separation of overlapping structures common with 2D mammography [41]. Also, early studies have reported that DBT detects as much as 40 percent more cancers than digital (2D) mammograms in breast cancer screening examinations [42].…”