scholarly journals The value of mammography in women with focal breast complaints in addition to initial targeted ultrasound

Author(s):  
L. Appelman ◽  
P. T. M. Appelman ◽  
C. C. N. Siebers ◽  
P. Bult ◽  
H. L. S. Go ◽  
...  

Abstract Purpose To determine the added value of mammography in women with focal breast complaints and the utility of initial targeted ultrasound in this setting. Methods Women with symptomatic breast disease who were evaluated by breast imaging (mammography/digital breast tomosynthesis and ultrasound) between January 2016 and December 2016 in the Radboud University Medical Centre were included. We retrospectively collected the following data: date of birth, indication of imaging, visibility on mammography/ultrasound, whether biopsy was taken, additional findings, BI-RADS-classification, pathology and follow-up results. Results A total of 494 women were included (mean age 46.5, range 30 to 93). In 49 women (9.9%), symptomatic breast cancer was diagnosed, all visible during targeted ultrasound. The negative predictive value of targeted ultrasound was very high (99.8%). Additional findings on mammography were significantly more often malignant when the symptomatic lesion was also malignant (3.8% vs 70%, P < 0.05). In only one patient with symptoms caused by a benign finding, an incidental malignancy was detected on mammography outside the area of complaint (detection rate 2.2/1000 examinations). Conclusions The contribution of mammography for cancer detection in women with focal breast complaints is very low when targeted ultrasound is performed. Additional findings are most common in patients with symptomatic breast cancer. Our results suggest that initial targeted ultrasound is a more appropriate initial tool for the evaluation of focal breast complaints. Mammography could be performed on indication only.

2021 ◽  
Vol 7 (9) ◽  
pp. 185
Author(s):  
Giovanna Romanucci ◽  
Lisa Zantedeschi ◽  
Anna Ventriglia ◽  
Sara Mercogliano ◽  
Maria Vittoria Bisighin ◽  
...  

Objectives: To compare the conspicuity of lobular breast cancers at digital breast tomosynthesis (DBT) versus synthesized 2D mammography (synt2D). Materials and methods: Seventy-six women (mean age 61.2 years, range 50–74 years) submitted to biopsy in our institution, from 2019 to 2021, with proven invasive lobular breast cancer (ILC) were enrolled in this retrospective study. The participants underwent DBT and synt2D. Five breast radiologists, with different years of experience in breast imaging, independently assigned a conspicuity score (ordinal 6-point scale) to DBT and synt2D. Lesion conspicuity was compared, for each reader, between the synt2D overall conspicuity interpretation and DBT overall conspicuity interpretation using a Wilcoxon matched pairs test. Results: A total of 50/78 (64%) cancers were detected on both synt2D and DBT by all the readers, while 28/78 (26%) cancers where not recognized by at least one reader on synt2D. For each reader, in comparison with synt2D, DBT increased significantly the conspicuity of ILC (p < 0.0001). The raw proportion of high versus low conspicuity by modality confirmed that cancers were more likely to have high conspicuity at DBT than synt2D. Conclusions: ILCs were more likely to have high conspicuity at DBT than at synt2D, increasing the chances of the detection of ILC breast cancer.


Author(s):  
Julian Hans Kleinknecht ◽  
Anca Ileana Ciurea ◽  
Cristiana Augusta Ciortea

Breast cancer screening programs using mammography proved their value in detecting breast cancer at early stages and, consequently, reducing the mortality from this disease. Due to the technological progress, the screening programs have shifted from screen-film mammography to digital mammography and nowadays digital breast tomosynthesis became the focus of breast imaging research. Using tomosynthesis in screening increases cancer detection rates and decreases recall and false-positive rates, thus improving the effectiveness of breast cancer screening programs, with positive consequences on health care costs and on patient psychology. More long-term follow-up data must be collected for assessing absolute sensitivity and specificity of digital breast tomosynthesis, together with efforts for addressing the limitations of the method.


2020 ◽  
Vol 17 (9) ◽  
pp. 4036-4040
Author(s):  
M. Veena ◽  
M. C. Padma

Breast cancer is a considerable prime cause which affects the lives of women’s and leads to death all around the world. A tumor is said to be malignancy if a number of cancerous cells can spread to other organs. There has been great impact on the field of medical imaging by the advancement of the computer technology as new and improved techniques of data acquisition, analysis, processing and visualization has evolved. A Digital Breast Tomosynthesis is used for the detection of breast cancer. This is also called as three-dimensional mammography, which eliminates the overlapping tissue problem. Digital Breast Tomosynthesis (DBT) provides information about potential abnormal tissues necessary for medical follow up and diagnosis. DBT gets additional importance in medical science as it is the only preliminary method of diagnosing a breast cancer with the dense breast. Early and accurate diagnosis can be sufficient in resolving various complications and guiding the patient with timely and proper treatment. By considering the above factors there is a great requirement to explore for DBT. The proposed work develops a computer aided methodology for automatic tumor detection and diagnosing in tomosynthesis Patient’s image. This method is incredibly helpful for doctors or the radiologist automatically locates the tumor space within the breast image for further surgery.


2019 ◽  
Vol 85 (8) ◽  
pp. 855-857
Author(s):  
Anthony M. Scott ◽  
Madison G. Lashley ◽  
Nicholas B. Drury ◽  
Paul S. Dale

The effect of mammographic screening on the natural history and evolution of breast cancer treatment cannot be overstated; however, despite intensive and resource consuming screening, advanced breast cancer is still diagnosed frequently. The development of three-dimensional mammography or digital breast tomosynthesis (DBT) has already demonstrated greater sensitivity in the diagnosis of breast pathology and effectiveness in identifying early breast cancers. In addition to being a more sensitive screening tool, other studies indicate DBT has a lower call-back rate when compared with traditional DM. This study compares call-back rates between these two screening tools. A single institution, retrospective review was conducted of almost 20,000 patient records who underwent digital mammography or DBTin the years 2016 to 2018. These charts were analyzed for documentation of imaging type, Breast Imaging Reporting and Data System 0 status, call-back status, and type of further imaging that was required. Charts for 19,863 patients were reviewed, 17,899 digital mammography examinations were conducted compared with 11,331 DBT examinations resulting in 1,066 and 689 Breast Imaging Reporting and Data System 0 studies, respectively. Of the DM call-backs, 82.08 per cent were recommended for additional radiographic imaging and 17.82 per cent for ultrasound imaging. In the DBT group, only 39.77 per cent of callbacks were recommended for additional radiographic imaging and 60.09 per cent for ultrasound imaging. Our data suggest that DBT results in less call-back for additional mammographic images as compared with digital mammography. DBT may offer benefits over DM, including less imaging before biopsy, less time before biopsy, quicker diagnosis, and improved patient satisfaction.


2019 ◽  
Vol 1 (1) ◽  
pp. 2-8
Author(s):  
Daniel B Kopans

Abstract The field of Breast Imaging evolved because a fairly small number of dedicated individuals realized the lifesaving potential of detecting breast cancer earlier. They persevered despite persistent efforts to curtail screening. From the first attempts to produce X-ray images of the breast to magnetic resonance and digital breast tomosynthesis, investigators have worked continuously to develop better ways to detect breast cancer at a time when cure is possible, while working continuously to preserve access for women to screening. Consequently, the death rate from breast cancer has declined by more than 40%. Therapy has improved, but therapy saves lives when breast cancers are treated early.


2018 ◽  
Vol 28 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Akram M. Asbeutah ◽  
Nouralhuda Karmani ◽  
AbdulAziz A. Asbeutah ◽  
Yasmin A. Echreshzadeh ◽  
Abdullah A. AlMajran ◽  
...  

Objective: To investigate the sensitivity and specificity of digital mammography (DM) and digital breast tomosynthesis (DBT) for the detection of breast cancer in comparison to histopathology findings. Subjects and Methods: We included 65 breast lesions in 58 women, each detected by two diagnostic mammography techniques – DM and DBT using Senographe Essential (GE Healthcare, Buc, France) – and subsequently confirmed by histopathology. The Breast Imaging Reporting and Data System was used for characterizing the lesions. Results: The average age of women was 48.3 years (range 26–81 years). There were 34 malignant and 31 benign breast lesions. The sensitivity of DM and DBT was 73.5 and 100%, respectively, while the specificity was 67.7 and 94%, respectively. Receiver operating characteristic curve analysis showed an overall diagnostic advantage of DBT over DM, with a significant difference between DBT and DM (p < 0.001). By performing Cohen’s kappa test, we found that there was a strong level of agreement according to Altman guidelines between DBT and histopathology findings (0.97), but a weak agreement between DM and histopathology findings (0.47). Conclusion: DBT improves the clinical accuracy of mammography by increasing both sensitivity and specificity. We believe that this improvement is due to improved image visibility and quality. These results could be of interest to health care institutions as they may impact their decision on whether to upgrade to DBT not only for diagnosis, but also for screening.


2019 ◽  
Vol 1 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Tisha Singer ◽  
Ana P Lourenco ◽  
Grayson L Baird ◽  
Martha B Mainiero

Abstract Objective To evaluate radiologists’ supplemental screening recommendations for women with dense breasts, at average, intermediate, or high risk of breast cancer, and to determine if there are differences between their recommendations for their patients, their friends and family, and themselves. Methods This is an anonymous survey of Society of Breast Imaging (SBI) members. Demographics, knowledge of breast density as a risk factor, and recommendations for screening with digital breast tomosynthesis (DBT), ultrasound (US), and magnetic resonance imaging (MRI) in women with dense breasts, at average, intermediate, or high- risk of breast cancer were assessed. The likelihood of their recommending the screening test for their patients, their family and friends, and themselves was assessed on a Likert scale from 0 to 4 (0 = “not at all likely” to 4 = “extremely likely”). Results There were 295 responses: 67% were women, and breast imaging comprised 95% of their practice. Among participants, 53% correctly answered the question on relative risk of breast cancer when comparing extremely dense versus fatty breasts, and 57% when comparing heterogeneously dense versus scattered breasts. US is recommended at a relatively low rate (1.0–1.4 on the 0–4 scale), regardless of risk. DBT is recommended at a relatively high rate (2.5–3.0 on the 0–4 scale), regardless of risk status. MR is recommended mainly for those at high risk (3.6 on the 0–4 scale). Radiologists were more likely to recommend additional imaging for themselves than for their patients and their family and friends. Conclusion For women with dense breasts, radiologists are “somewhat likely” to recommend US and “likely” to “very likely” to recommend DBT regardless of risk group. They are “very likely” to recommend MRI for high-risk groups.


Breast Care ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. 218-222 ◽  
Author(s):  
Francesca Galati ◽  
Flaminia Marzocca ◽  
Erica Bassetti ◽  
Maria L. Luciani ◽  
Sharon Tan ◽  
...  

Background: The aim of this study was to evaluate the added value of digital breast tomosynthesis (DBT) when combined with digital mammography (DM) in BI-RADS assessment and follow-up management. Methods: From February 2014 to January 2015, 214 patients underwent DM and DBT, acquired with a Siemens Mammomat Inspiration unit. 2 expert readers independently reviewed the studies in 2 steps: DM and DM+DBT, according to BI-RADS rate. Patients with BI-RADS 0, 3, 4, and 5 were recalled for work-up. Inter-reader agreement for BI-RADS rate and work-up rate were evaluated using Cohen's kappa. Results: Inter-reader agreement (κ value) for BI-RADS classification was 0.58 for DM and 0.8 for DM+DBT. DM+DBT increased the number of BI-RADS 1, 2, 4, 5 and reduced the number of BI-RADS 0 and 3 for both readers compared to DM alone. Regarding work-up rate agreement, κ was poor for DM and substantial (0.7) for DM+DBT. DM+DBT also reduced the work-up rate for both Reader 1 and Reader 2. Conclusion: DM+DBT increased the number of negative and benign cases (BI-RADS 1 and 2) and suspicious and malignant cases (BI-RADS 4 and 5), while it reduced the number of BI-RADS 0 and 3. DM+DBT also improved inter-reader agreement and reduced the overall recall for additional imaging or short-interval follow-up.


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