Associating Automated Breast Ultrasound (ABUS) and Digital Breast Tomosynthesis (DBT) with Full-Field Digital Mammography (FFDM) in Clinical Practice in Cases of Women with Dense Breast Tissue

Abstract

The purpose of the present study was to evaluate the value of full-field digital mammography (FFDM) and automated breast ultrasound (ABUS) in the diagnosis of breast cancer compared to FFDM associated with digital breast tomosynthesis (DBT). Methods: This retrospective study included 50 female patients with a denser framework of connective tissue fibers, characteristic of young women who underwent FFDM, DBT, handheld ultrasound (HHUS), and ABUS between January 2017 and October 2018. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy of FFDM+ABUS were 81.82% (95% CI [48.22–97.72]), 89.74% (95% CI [75.78–97.13]), 69.23% (95% CI [46.05–85.57]), 94.59% (95% CI [83.26–98.40]), and 88% (95% CI [75.69–95.47]), while for FFDM+DBT, the values were as follows: 91.67% (95% CI [61.52–99.79]), 71.79% (95% CI [55.13–85.00]), 50% (95% CI [37.08–62.92]), 96.55% (95% CI [80.93–99.46]), 76.47% (95% CI [62.51–87.21]). We found an almost perfect agreement between the two readers regarding FFDM associated with ABUS, and substantial agreement regarding FFDM+DBT, with a kappa coefficient of 0.896 and 0.8, respectively; p < 0.001. Conclusions: ABUS and DBT are suitable as additional diagnostic imaging techniques to FFDM in women at an intermediate risk of developing breast cancer through the presence of dense breast tissue. In this study, DBT reduced the number of false negative results, while the use of ABUS resulted in an increase in specificity.

Keywords

• full-field digital mammography (FFDM)
• digital breast tomosynthesis (DBT)
• automated breast ultrasound (ABUS)
• dense breast tissue