The Value Of Digital Breast Tomosynthesis For Diagnosing Breast Cancers In Dense Breast

ObjectiveIn recent years,the incidence and mortality of breast cancer are obviously rising.Early detection,diagnosis and treatment of breast cancer are becoming more and more important.Full-field digital mammography(FFDM)is the preferred examination method of breast tumor,but it is easily affected by the overlap of glandular tissue and lead to misdiagnosis and missed diagnosis as result,especially for dense breast.Digital breast tomosynthesis(DBT)is a new technique for breast examination,which can effectively reduce or eliminate the effect of the overlap of the gland.This study aims to clarify the advantage of DBT on FFDM in evaluating breast cancers in dense breast.MethodsAll of the patients who had suspicious breast cancers underwent bilateral breast FFDM examination,and DBT examination for the breast with suspicious lesions.The patterns of breast density were evaluated and recorded.The shape,size,number,border and edge of the lesions,spiculation,vascular entry sign and the shape and distribution of calcification,and BI-RADS scores of images were assessed.Finally,the differences between DBT and FFDM in detection rate,showing of lesion features and diagnostic accuracy of breast cancers in dense breast were respectively evaluated based on histopathological results.Results445 lesions were confirmed as breast cancers in 443 patients with dense breasts.The total detection rate of DBT was significantly higher than that of FFDM(94.8%vs.77.8%,P<0.05),of which DBT was more sensitive for masses without calcification than FFDM(64.5%vs.48.3%,P<0.05),but there was no significant difference between them for masses with calcification(χ2=2.571,P=0.109).For calcification alone and other types of lesions,the detection rate of DBT was lower than that of FFDM(P<0.05).DBT showed obviously more details than FFDM,including the border of masses,spiculation and vascular entry sign(P<0.05),but there was no difference in calcification(P>0.05).Meanwhile,DBT also had significantly higher diagnostic accuracy for lesions than FFDM(74.4%vs.44.7%,P<0.05),especially for masses without calcification(76.8%vs.55.1%,P<0.05),but there was no significant difference between them for masses with calcification,χ2=2.801,P=0.094).There was no significant difference in the diagnostic accuracy of DBT and FFDM for calcification alone and other types of lesions(P>0.05).ConclusionsCompared with FFDM,DBT is more sensitive for detecting masses,especially those without calcification in dense breast,and it can better display the details of the lesion’s shape,number,boundary,edge,spiculation,vascular entry sign and so on.Additionally,it can also significantly improve their diagnostic accuracy.Therefore,DBT is more suitable for evaluating the suspicious breast cancers in dense breast.