Ann Yi1,2, Jung Min Chang1, Sung Ui Shin1,2, A Jung Chu1, Nariya Cho1, Dong-Young Noh3, Woo Kyung Moon1. 1. Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea. 3. Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Abstract
OBJECTIVE: To evaluate the tumour visibility and diagnostic performance of digital breast tomosynthesis (DBT) in patients with noncalcified T1 breast cancer. METHODS: Medical records of 106 females with noncalcified T1 invasive breast cancer who underwent DBT and full-field digital mammography (FFDM) between January 2012 and December 2014 were retrospectively reviewed. To assess tumour visibility (score 1-3), all DBT and FFDM images were reviewed by two radiologists blinded to clinicopathological information. A reference standard was established by an unblinded consensus review of all images. Clinicopathological and imaging variables were analysed based on tumour visibility. After adding 159 negative controls, the diagnostic performance of DBT + FFDM was compared with that of FFDM. RESULTS: The tumour visibility was significantly higher through DBT + FFDM (2.5 vs 1.8; p = 0.002) than FFDM alone. Breast composition was the independent variable for tumour visibility through DBT + FFDM (extremely dense; odds ratio, 0.02; p < 0.001). Sensitivity (p = 0.642), specificity (p = 0.463), positive-predictive value (p = 0.078), and negative-predictive value (p = 0.072) of DBT + FFDM were not significantly superior to those of FFDM in 55 females with extremely dense breast composition, whereas specificity (p = 0.002) and positive-predictive value (p < 0.001) were significantly higher in 210 females with other breast compositions. CONCLUSION: Addition of DBT to FFDM showed no significant increase in the tumour visibility and diagnostic performance in patients with noncalcified T1 cancer in extremely dense breasts. ADVANCES IN KNOWLEDGE: Addition of DBT to FFDM did not further improve the detection of noncalcified early breast cancers in females with extremely dense breasts.
OBJECTIVE: To evaluate the tumour visibility and diagnostic performance of digital breast tomosynthesis (DBT) in patients with noncalcified T1 breast cancer. METHODS: Medical records of 106 females with noncalcified T1 invasive breast cancer who underwent DBT and full-field digital mammography (FFDM) between January 2012 and December 2014 were retrospectively reviewed. To assess tumour visibility (score 1-3), all DBT and FFDM images were reviewed by two radiologists blinded to clinicopathological information. A reference standard was established by an unblinded consensus review of all images. Clinicopathological and imaging variables were analysed based on tumour visibility. After adding 159 negative controls, the diagnostic performance of DBT + FFDM was compared with that of FFDM. RESULTS: The tumour visibility was significantly higher through DBT + FFDM (2.5 vs 1.8; p = 0.002) than FFDM alone. Breast composition was the independent variable for tumour visibility through DBT + FFDM (extremely dense; odds ratio, 0.02; p < 0.001). Sensitivity (p = 0.642), specificity (p = 0.463), positive-predictive value (p = 0.078), and negative-predictive value (p = 0.072) of DBT + FFDM were not significantly superior to those of FFDM in 55 females with extremely dense breast composition, whereas specificity (p = 0.002) and positive-predictive value (p < 0.001) were significantly higher in 210 females with other breast compositions. CONCLUSION: Addition of DBT to FFDM showed no significant increase in the tumour visibility and diagnostic performance in patients with noncalcified T1 cancer in extremely dense breasts. ADVANCES IN KNOWLEDGE: Addition of DBT to FFDM did not further improve the detection of noncalcified early breast cancers in females with extremely dense breasts.
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