Diagnostic Accuracy of Full-Field Digital Mammography and Digital Breast Tomosynthesis in the Evaluation of Breast Lesions
Yashaswini Basaboina1* and Rohini Avansta2
1Post Graduate, Department of Radiodiagnosis, K.S. Hegde Medical Academy, NITTE University, India
2Additional Professor, Department of Radiodiagnosis, K.S. Hegde Medical Academy, NITTE University, India
*Corresponding Author: Rohini Avansta, Additional Professor, Department of Radiodiagnosis, K.S. Hegde Medical Academy, NITTE University, India.
May 13, 2023; Published: May 29, 2023
Aim/Objectives: This study aimed to evaluate the diagnostic accuracy of full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in detecting and characterizing the lesions. Also, we compared both modalities in detecting breast lesions.
Methods: A prospective study was conducted from January 2021 to June 2022 on 76 patients. All of them underwent FFDM, DBT, and ultrasonography (USG), and the features of breast lesions were characterized based on the BIRADS followed by histopathological confirmation.
Results: This study found that DBT (97.3%) was more accurate than FFDM (88.4%) in detecting breast lesions and is superior to FFDM when used alone or as an adjunctive tool for FFDM. The sensitivity of DBT vs FFDM (100% vs 92%) and DBT +FFDM vs FFDM (100% vs 92%) was relatively higher. Also, the specificity of DBT vs FFDM was 91.4% vs 76.7% and FFDM+DBT vs FFDM was 89.8% vs 76.7%.
The individual characteristics of breast lesions with the highest sensitivity were spiculations, lobulations, and architectural distortion being 100% for all on DBT and 90.9%, 88%, and 80.8% on FFDM respectively. They also showed high specificity of 96% for spiculations and architectural distortion, 90% for lobulations on DBT and 90% for spiculations, 50% for lobulations, and 84.3% for architectural distortion on FFDM. Calcifications showed high sensitivity of 95.2% on DBT. The features favoring malignancy on DBT and FFDM were spiculated margins, architectural distortion, microlobulations, microcalcifications, irregularly shaped lesions with irregular margins, and also, >2cm size of the lesion. With the addition of DBT to FFDM, 14 out of 76 lesions had shown up gradation on BIRADS.
Conclusion: The performance of DBT was significantly higher for the detection and characterization of breast lesions. Evaluation of the features of breast lesions on DBT can help to identify the malignant and benign potential of the lesions. The addition of DBT as a screening tool can decrease false positives and recall rates as well.
Keywords: Digital Breast Tomosynthesis; Digital Mammography; Breast Lesions; BIRADS; Breast Cancer
- Singla D., et al. “Comparing the diagnostic efficacy of full field digital mammography with digital breast tomosynthesis using BIRADS score in a tertiary cancer care hospital”. Indian Journal of Radiology Imaging1 (2021): 115-122.
- Malvia S., et al. “Epidemiology of breast cancer in Indian women”. Asia-Pacific Journal of Clinical Oncology4 (2017): 289-295.
- Majeed W., et al. “Breast Cancer: Major Risk Factors and Recent Developments in Treatment”. Asian Pacific Journal of Cancer Prevention 8 (2014): 3353-3358.
- Gokhale S. “Ultrasound characterization of breast masses”. Indian Journal of Radiology Imaging 19 (2009): 242-247.
- Gershon-Cohen J., et al. “Roentgenography of breast cancer moderating concept of “Biologic predeterminism”. Cancer 8 (1963): 961-964.
- Chae EY., et al. “Detection and characterization of breast lesions in a selective diagnostic population: diagnostic accuracy study for comparison between one-view digital breast tomosynthesis and two-view full-field digital mammography”. British Journal of Radiology 1062 (2016): 20150743.
- Jayadeva Phurailatpam., et al. “Evaluation of Mammography, Sonomammography in Correlation with Fine Needle Aspiration of Breast Lumps” (2014).
- Andersson I., et al. “Breast tomosynthesis and digital mammography: a comparison of breast cancer visibility and BIRADS classification in a population of cancers with subtle mammographic findings”. European Radiology12 (2008): 2817-2825.
- Mishra N., et al. “Localization of Breast Lesion Using Mammographic-Basic Views”. Clinical Immunology and Infectious Diseases 1 (2018).
- Naeim R., et al. “Comparing the diagnostic efficacy of digital breast tomosynthesis with full-field digital mammography using BI-RADS scoring”. Egyptian Journal of Radiology and Nuclear Medicine (2021): 52.
- Svahn TM., et al. “Breast tomosynthesis and digital mammography: a comparison of diagnostic accuracy”. British Journal of Radiology 1019 (2012): e1074-1082.
- Holzer-Fruehwald L., et al. “Can Cut-Off-Values for Tumor Size or Patient Age in Breast Ultrasound Reduce Unnecessary Biopsies or is it all About Bi-rads?- A Retrospective Analysis of 763 Biopsied T1-Sized Lesions” (2017).
- Lei J., et al. “Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis”. European Radiology3 (2014): 595-602.
- Jung Min Changa., et al. “Radiologists’ performance in the detection of benign and malignant masses with 3D automated breast ultrasound (ABUS)” (2011).
- Samia Aboelnour Abdeltwab Abdelattef., et al. “Three-dimensional tomosynthesis versus two-dimensional mammography in detection and characterization of different breast lesions”. Egyptian Journal of Radiology and Nuclear Medicine (2019).
- Hashem LMB., et al. “Characterization of breast masses: a comparative study between automated breast ultrasound (ABUS) and digital breast tomosynthesis (DBT)”. Egyptian Journal of Radiology and Nuclear Medicine 1 (2020): 47.
- Amer HA., et al. “Digital breast tomosynthesis versus full-field digital mammography—Which modality provides more accurate prediction of margin status in specimen radiography?” European Journal of Radiology 93 (2017): 258-264.
- Henrot P., et al. “Breast microcalcifications: The lesions in anatomical pathology”. Diagnostic and Interventional Imaging 2 (2014): 141-152.
- I Leichter1, R. Lederman2, S. S. Buchbinder3 4, P. Bamberger5, B. Novak1 and S. Fields, Read More: https://I. Leichter1, R. Lederman2, S. S. Buchbinder3 4, P. Bamberger5, B. Novak1 and S. Fields, Read More: https://wLeichter1, R. Lederman2, S. S. Buchbinder3 4.
- Li J., et al. “Diagnostic Performance of Digital Breast Tomosynthesis for Breast Suspicious Calcifications From Various Populations: A Comparison With Full-field Digital Mammography”. Computational and Structural Biotechnology Journal 17 (2019): 82-89.
- Infiltrating Ductal Carcinoma - features of solid nodules. Breast Cancer - Moose and Doc. (2019).
- Franquet T., et al. “Spiculated lesions of the breast: mammographic-pathologic correlation”. RadioGraphics (1993).
- Moishe Liberman., et al. “Breast cancer diagnosis by scintimammography: a meta-analysis and review of the literature” (2003).
- Mariscotti G., et al. “Accuracy of Mammography, Digital Breast Tomosynthesis, Ultrasound and MR Imaging in Preoperative Assessment of Breast Cancer”. ANTICANCER Research (2014).