Comparative study between breast tomosynthesis and classic digital mammography in the evaluation of different breast lesions

Abstract

Objective: To evaluate the impact of adding 3D Tomosynthesis to Full Field Digital Mammography (FFDM) in the detection and diagnosis of breast lesions. Subjects and methods: The study included 166 mammograms with indeterminate findings selected from 1600 mammograms. They were classified into two groups: group 1 ‘Diagnostic mammograms’ of symptomatic women and group 2 ‘Screening mammograms’. Dense breasts assigned as ACR3 and ACR4 presented 69% (n = 114/166) of the studied cases. FFDM and 3D tomosynthesis examination was done and imaging findings were evaluated before and after the use of 3D tomosynthesis images. Results: Both modalities were compared regarding detection and diagnosis, each individually assessed, using the Pearson Chi Square tests. Detection (P value: 0.006) and diagnosis (P value: 0.048) of breast lesions dramatically improved when 3D tomosynthesis images were considered in the evaluation. The sensitivity, specificity, and accuracy of digital mammography was 60%, 20.7% and 48% have significantly enhanced on applying tomosynthesis to be 94.5%, 74% and 89.7%. Conclusion: Three-dimensional tomosynthesis significantly enhanced the detection and characterization of breast lesions on digital mammography especially in the context of dense breast parenchyma (ACR 3&4).

Keywords

• Breast
• Digital mammography
• Biopsy
• Computer applications-3D
• Calcifications