Rabea Haq1, Yit Y Lim1,2, Anthony J Maxwell1,2, Emma Hurley1, Ursula Beetles1, Sara Bundred1, Mary Wilson1, Susan Astley2, Fiona J Gilbert3. 1. 1 Nightingale Centre and Genesis Prevention Centre, University Hospital South Manchester NHS Trust, Manchester, UK. 2. 2 Centre for Imaging Sciences, Institute of Population Health, University of Manchester, Manchester, UK. 3. 3 Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
Abstract
OBJECTIVE: The current recommendation from the UK National Health Service Breast Screening Programme is that digital breast tomosynthesis (DBT) can be used for further assessment of possible screen-detected soft-tissue abnormalities in place of spot compression views and when used should be performed in two projections. The aim of the study was to assess whether two-view DBT is necessary if the abnormality is seen only in one view on initial full-field digital mammography (FFDM). METHODS: 617 cases with possible masses, distortions and asymmetrical densities visualized only in one view on screening FFDM were included. All of these females underwent two-view DBT, clinical examination and ultrasound. The FFDM and DBT findings on each view were compared and correlated with the histological diagnosis. RESULTS: 586 of 617 cases had normal or benign findings on further assessment, and no additional information was obtained on the other DBT view. There were 31 confirmed cancers. In 26 cases (84%), the cancer was seen on the corresponding DBT view. No cancer was seen on the other DBT view alone. Five cancers (16%) were not seen on either view on DBT owing to technical reasons. No cancers would have been missed if only the corresponding DBT view was performed. CONCLUSION: Two-view DBT may not be necessary when used for further assessment of possible screen-detected soft-tissue abnormalities. Larger studies should be undertaken to investigate this further. ADVANCES IN KNOWLEDGE: One-view DBT may be adequate in assessing soft-tissue abnormalities seen only on one FFDM view.
OBJECTIVE: The current recommendation from the UK National Health Service Breast Screening Programme is that digital breast tomosynthesis (DBT) can be used for further assessment of possible screen-detected soft-tissue abnormalities in place of spot compression views and when used should be performed in two projections. The aim of the study was to assess whether two-view DBT is necessary if the abnormality is seen only in one view on initial full-field digital mammography (FFDM). METHODS: 617 cases with possible masses, distortions and asymmetrical densities visualized only in one view on screening FFDM were included. All of these females underwent two-view DBT, clinical examination and ultrasound. The FFDM and DBT findings on each view were compared and correlated with the histological diagnosis. RESULTS: 586 of 617 cases had normal or benign findings on further assessment, and no additional information was obtained on the other DBT view. There were 31 confirmed cancers. In 26 cases (84%), the cancer was seen on the corresponding DBT view. No cancer was seen on the other DBT view alone. Five cancers (16%) were not seen on either view on DBT owing to technical reasons. No cancers would have been missed if only the corresponding DBT view was performed. CONCLUSION: Two-view DBT may not be necessary when used for further assessment of possible screen-detected soft-tissue abnormalities. Larger studies should be undertaken to investigate this further. ADVANCES IN KNOWLEDGE: One-view DBT may be adequate in assessing soft-tissue abnormalities seen only on one FFDM view.
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