The value of tomosynthesis in mammographically detected questionable breast lesions

Safwat, Hadeer Khaled; Khalifa, Dalia Nabil; Nada, Omnia Mokhtar; Hassanin, Ali M.

doi:10.21608/zumj.2020.15624.1396

The value of tomosynthesis in mammographically detected questionable breast lesions

Document Type : Original Article

Authors

¹ Radiology department Zagazig University hospitals

² Radiology department, Zagazig University Hospitals

³ Radiology department, National Cancer Institute, Cairo University

⁴ Radiology department , Zagazig University Hospitals

10.21608/zumj.2020.15624.1396

Abstract

Tomosynthesis is a new technique for evaluation of the breast lesions that can overcome the problem of overlapping breast tissue especially in dense breast. So it can be used for better evaluation of breast lesion with advantages over digital mammography in accurate detection of margins, precise localization of the lesion and reduction of false positive recalls.
PATIENTS AND METHODS: eighty patients with questionable mammographic breast lesion BIRADS III &IV were encountered in the study and subjected to clinical assessment including full history taking, clinical examination and imaging assessment by DBT. Both modalities were independently reported as a part of the diagnostic procedure, we determined the BI-RADS category of the lesions in each of the 2 imaging modalities individually according to the BI-RADS lexicon 2013 classification, guided by the results of mammographic findings.
RESULTS: Both modalities were compared regarding detection and diagnosis, each individually assessed, using the Pearson Chi Square tests. Detection and diagnosis of breast lesions improved when adding 3D tomosynthesis. The sensitivity, specificity, the positive predictive value, the negative predictive value and accuracy of digital mammography was 62.5%, 59%, 52.1%, 68.8%, and 60.4% compared to tomosynthesis which was 90%, 91.1%, 88%, 92.7% and 91%.
CONCLUSIONS: we concluded that Tomosynthesis separates overlapping tissue in dense breast by acquisition of multiple images over limited angular range. Tomosynthesis showed higher sensitivity and specificity and diagnostic accuracy than Mammography as it allows better detection of breast cancer, characterization of lesions, better margin assessment of masses and decrease false positive recall rate.

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