Jin You Kim1,2, Hyun Jung Kang1, Jong Ki Shin2, Nam Kyung Lee1, You Seon Song1, Kyung Jin Nam3, Ki Seok Choo3. 1. 1 Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea. 2. 2 Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea. 3. 3 Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Abstract
OBJECTIVE: The purpose of this study was to analyze the clinicopathologic and immunohistochemical features of invasive breast cancers detected only with digital breast tomosynthesis (DBT), compared with those of cancers detected with both DBT and full-field digital mammography (FFDM). MATERIALS AND METHODS: The medical records of 261 women (108 without and 153 with symptoms) with invasive breast cancers who underwent FFDM and DBT between April 2015 and June 2016 were retrospectively reviewed. To assess detectability, all DBT and FFDM images were reviewed independently by three radiologists blinded to clinicopathologic information. The reference standard was established by an unblinded consensus review of all images. Clinicopathologic and immunohistochemical features were analyzed according to the detectability status. RESULTS: Of the 261 cancers, 223 (85.4%) were detected with both DBT and FFDM (both-detected group). Twenty-four cancers (9.2%) not detected with FFDM (DBT-only group) were classified by DBT as a mass (58.3%), architectural distortion (33.3%), or asymmetry (8.3%). The remaining 14 cancers (5.4%) were not detected with either DBT or FFDM (both-occult group). On multivariate analysis, a dense breast parenchyma (p = 0.007), small tumor size (≤ 2 cm; p = 0.027), and luminal A-like subtype (estrogen receptor positive or progesterone receptor positive or both, human epidermal growth factor receptor 2 negative, and Ki-67 expression < 14%; p = 0.008) were significantly associated with the DBT-only group. For 108 screening-detected cancers, a dense breast parenchyma (p = 0.007) and luminal A-like subtype (p = 0.008) also maintained significance. CONCLUSION: The addition of DBT to FFDM in screening would aid in the detection of less-aggressive subtypes of invasive breast cancers in women with dense breasts.
OBJECTIVE: The purpose of this study was to analyze the clinicopathologic and immunohistochemical features of invasive breast cancers detected only with digital breast tomosynthesis (DBT), compared with those of cancers detected with both DBT and full-field digital mammography (FFDM). MATERIALS AND METHODS: The medical records of 261 women (108 without and 153 with symptoms) with invasive breast cancers who underwent FFDM and DBT between April 2015 and June 2016 were retrospectively reviewed. To assess detectability, all DBT and FFDM images were reviewed independently by three radiologists blinded to clinicopathologic information. The reference standard was established by an unblinded consensus review of all images. Clinicopathologic and immunohistochemical features were analyzed according to the detectability status. RESULTS: Of the 261 cancers, 223 (85.4%) were detected with both DBT and FFDM (both-detected group). Twenty-four cancers (9.2%) not detected with FFDM (DBT-only group) were classified by DBT as a mass (58.3%), architectural distortion (33.3%), or asymmetry (8.3%). The remaining 14 cancers (5.4%) were not detected with either DBT or FFDM (both-occult group). On multivariate analysis, a dense breast parenchyma (p = 0.007), small tumor size (≤ 2 cm; p = 0.027), and luminal A-like subtype (estrogen receptor positive or progesterone receptor positive or both, humanepidermal growth factor receptor 2 negative, and Ki-67 expression < 14%; p = 0.008) were significantly associated with the DBT-only group. For 108 screening-detected cancers, a dense breast parenchyma (p = 0.007) and luminal A-like subtype (p = 0.008) also maintained significance. CONCLUSION: The addition of DBT to FFDM in screening would aid in the detection of less-aggressive subtypes of invasive breast cancers in women with dense breasts.
Entities:
Keywords:
breast density; breast neoplasms; digital breast tomosynthesis; digital mammography; subtypes
Authors: Emily F Conant; Samantha P Zuckerman; Elizabeth S McDonald; Susan P Weinstein; Katrina E Korhonen; Julia A Birnbaum; Jennifer D Tobey; Mitchell D Schnall; Rebecca A Hubbard Journal: Radiology Date: 2020-03-10 Impact factor: 11.105
Authors: Emily F Conant; William E Barlow; Sally D Herschorn; Donald L Weaver; Elisabeth F Beaber; Anna N A Tosteson; Jennifer S Haas; Kathryn P Lowry; Natasha K Stout; Amy Trentham-Dietz; Roberta M diFlorio-Alexander; Christopher I Li; Mitchell D Schnall; Tracy Onega; Brian L Sprague Journal: JAMA Oncol Date: 2019-05-01 Impact factor: 31.777
Authors: Wendie A Berg; Elizabeth A Rafferty; Sarah M Friedewald; Carrie B Hruska; Habib Rahbar Journal: AJR Am J Roentgenol Date: 2020-12-23 Impact factor: 3.959
Authors: Soo Hyun Lee; Mi Jung Jang; Sun Mi Kim; Bo La Yun; Jiwon Rim; Jung Min Chang; Bohyoung Kim; Hye Young Choi Journal: Korean J Radiol Date: 2018-12-27 Impact factor: 3.500