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Benefits of digital breast tomosynthesis: A lesion-level analysis. | LitMetric

Benefits of digital breast tomosynthesis: A lesion-level analysis.

J Med Screen

The Russell H. Morgan Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Published: September 2021

AI Article Synopsis

  • - The study aimed to evaluate the performance of digital breast tomosynthesis (DBT) against full-field digital mammogram (FFDM) in breast cancer screening, focusing on recall rates, biopsy recommendations, and malignancy likelihood based on lesion types.
  • - Out of 22,055 screening mammograms analyzed, DBT demonstrated a lower recall rate (8.0%) compared to FFDM (10.6%), particularly excelling in detecting architectural distortion, which correlated with a higher malignancy risk.
  • - While DBT reduced recall rates for asymmetries, it increased the likelihood of those lesions being recommended for biopsy; calcifications remained challenging to interpret regardless of the screening method.

Article Abstract

Objective: To compare outcome metrics of digital breast tomosynthesis (DBT) breast cancer screening with full-field digital mammogram (FFDM); specifically, to compare recall rates by the type of recalled finding, and to assess if screening with DBT versus FFDM changes biopsy recommendations and if the likelihood of malignancy varied by lesion type, if detected on DBT or FFDM screening mammogram.

Methods: The outcomes of 22,055 FFDM and DBT screening mammograms were retrospectively reviewed. The exams were performed at an academic institution between August 2015 and September 2016. Performance of screening with FFDM versus DBT was compared in terms of recall rate and percentage of recalled lesions resulting in a cancer diagnosis, with subset analyses performed for specific mammographic findings.

Results: The recall rate was 10.6% for FFDM and 8.0% for DBT ( < 0.001). Architectural distortion was more likely to be recalled on DBT screening than FFDM ( = 0.002), and was associated with an increased likelihood of malignancy ( = 0.008). Asymmetries were less likely to be recalled on DBT than FFDM ( < 0.001) screening mammogram, but more likely to be recommended for biopsy when detected on DBT. Calcifications more frequently required short-term follow-up or biopsy on both DBT and FFDM.

Conclusions: DBT screening confers an advantage in detection of architectural distortion representing malignancy. Recall rate of asymmetries are reduced with screening DBT, probably due to reduction of tissue superimposition. Calcifications pose a particularly difficult diagnostic challenge for breast imagers, regardless of screening mammogram type.

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Source
http://dx.doi.org/10.1177/0969141320978267DOI Listing

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