The role of digital breast tomosynthesis in diagnosis of breast cancer

Dr Lai Thu Huong1, Dr Luu Hong Nhung1, professor Pham Minh Thong1
1 Faculty of College of Medicine, Hospital Bach Mai

Main Article Content

Abstract

purpose of this study is to describe some imaging findings and evaluate the role of digital breast tomosynthesis (DBT) in diagnosis of breast cancer. The study was conducted on 59 breasts of 59 patients with clinical signs or abnormal imaging findings. The malignant or benign nature of the lesions was established by histologic analysis of biopsied lesions or FNA
with follow-up.
Result: The common manifestations of cancer noted at DBT include ill-defined mass, speculated margins, architectural
distortion and microcalcifications. DBT improved diagnostic sensitivity for patients with mass and architectural distortion, and
allows a reclassification of the degree of BI-RADS. There was slight to fair agreement for lesion type (k= 0 - 0.25) and BI-RADS
final assessment (k = 0.285 - 0.396). DBT improved diagnostic performance compared to MMG, with Se = 94.9%, Sp = 75%,
PPV = 88.1%, NPV = 88.2%, Vg = 88.1%.
Conclusion: Our study showed fair agreement in lesion detection and characterization between MMG and DBT images.
Our findings also demonstrated that DBT is a novel technique that superior in detecting and diagnosing breast cancer compared to MMG, especially in mass and architectural distortion.

Article Details

References

1. Erlay J SI, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D. Cancer Incidence and Mortality Worldwide.
2. Phí Ích Nghị, Võ Tấn Đức, Trương Hiếu Nghĩa. Hình ảnh học tuyến vú và tầm soát ung thư vú. thành phố Hồ Chí Minh: Nhà xuất bản y học; 2009.
3. Humphrey LL, Helfand M, Chan BK, Woolf SH. Breast cancer screening: a summary of the evidence for the US Preventive Services Task Force. Annals of internal medicine. 2002;137(5_Part_1):347-60.
4. Carney PA, Miglioretti DL, Yankaskas BC, Kerlikowske K, Rosenberg R, Rutter CM, et al. Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Annals of internal medicine. 2003;138(3):168-75.
5. Andersson I, Ikeda DM, Zackrisson S, Ruschin M, Svahn T, Timberg P, 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 radiology. 2008;18(12):2817-25.
6. Skaane P, Bandos AI, Gullien R, Eben EB, Ekseth U, Haakenaasen U, et al. Comparison of digital mammography alone and digital mammography
plus tomosynthesis in a population-based screening program. Radiology. 2013;267(1):47-56.
7. Takamoto Y, Tsunoda H, Kikuchi M, Hayashi N, Honda S, Koyama T, et al. Role of breast tomosynthesis in diagnosis of breast cancer for Japanese women. Asian Pacific journal of cancer prevention : APJCP. 2013;14(5):3037-40.
8. Mansour S, Adel L, Mokhtar O, Omar OS. Comparative study between breast tomosynthesis and classic digital mammography in the evaluation
of different breast lesions. The Egyptian Journal of Radiology and Nuclear Medicine. 2014;45(3):1053-61.
9. D’Orsi CJ. ACR BI-RADS Atlas: Breast Imaging Reporting and Data System2013.
10. Đỗ Doãn Thuận. Nghiên cứu giá trị của chụp Xquang và siêu âm trong chẩn đoán ung thư vú. 2008.
11. Nguyễn Thị Hồng Phượng. Lợi ích của chẩn đoán hình ảnh trong những ung thư vú đánh dấu tiền phẫu thuật. Nghiên cứu y học chuyên đề ung thư Nghiên cứu y học TP Hồ Chí Minh. 2003;7:340-8.
12. Kim SA, Chang JM, Cho N, Yi A, Moon WK. Characterization of breast lesions: comparison of digital breast tomosynthesis and ultrasonography. Korean journal of radiology. 2015;16(2):229-38.
13. Zuley ML, Bandos AI, Ganott MA, Sumkin JH, Kelly AE, Catullo VJ, et al. Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology. 2013;266(1):89-95.
14. Mun H, Kim H, Shin H, Cha J, Ruppel P, Oh H, et al. Assessment of extent of breast cancer: comparison between digital breast tomosynthesis
and full-field digital mammography. Clinical radiology. 2013;68(12):1254-9.
15. Dang P, Humphrey K, Freer P, Halpern E, Saksena M, Rafferty E. Comparison of lesion detection and characterization in invasive cancers using breast tomosynthesis versus conventional mammography Radiological Society of North America Scientific Assembly and Annual Meeting Program Oak Brook, Ill: Radiological Society of North America. 2013;156.
16. March D. Making the Diagnosis: A Practical Guide to Breast Imaging. 2013.
17. Takamoto Y, Tsunoda H, Kikuchi M, Hayashi N, Honda S, Koyama T, et al. Role of breast tomosynthesis in diagnosis of breast cancer for Japanese women. Asian Pacific Journal of Cancer Prevention. 2013;14(5):3037-40.
18. J L, P Y, L Z, al e. Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a metaanalysis. Eur Radiol. 2014;24:595-602.