The Diagnostic Efficacy of Digital Breast Tomosynthesis Comparing with Full-Field Digital Mammography in screening in Women with Dense Breast Using BI-RADS Scoring

Abstract

Background: Mammography stands as the predominant breast screening method, having demonstrated efficacy in lowering mortality associated with breast cancer. However recent research has uncovered the constraints of mammography, particularly in women with breast tissue characterized by high density. Digital Breast Tomosynthesis (DBT) involves reconstructing tomographic images from various projections captured at different angles. This method enables the creation of 3D data, minimizing tissue overlap and enhancing the assessment of masses, architectural distortion, and asymmetries when compared to conventional two-dimensional mammographic images. Objective: is to evaluate the diagnostic efficacy of 3D digital breast tomosynthesis in screening of breast cancer. Patients and methods: Prospective study for 50 women with dense breast who presented to radiodiagnosis and medical imaging department at the National Cancer Institute for screening purposes between march 2019 to march 2021 with mean age 43.5 ± 5.4. Mammography and Digital breast tomosynthesis were done for all patients. Lesions were evaluated on DM; DBT alone then combined DBT & DM. Comparison of results according to changes in BIRADS, diagnostic performance using histopathology as gold standard. Results: 50 women with dense breast underwent conventional mammography that detected (12 asymmetry, 26 masses, 4 micro calcifications), Tomosynthesis reduced the BIRADS 3 count by 39%, upgraded the count of BIRADS 4 lesions by 27.2% with consequent improvement of sensitivity and specificity, PPV, NPV and accuracy to 97%, 90%, 97%,90%, and 96%. Conclusion: DBT improved the diagnostic performance and proper BIRADS categorization in evaluation of the lesions in dense breast.