Comparative Study Of Digital Breast Tomosynthesis And Ultrasound In The Diagnosis Of Dense Breasts

Objective: To compare the diagnostic performance of digital breast tomosynthesis(DBT)and ultrasound in women with dense breasts.Methods: Collected the patients with dense breasts who underwent DBT and ultrasound examinations in Shengjing Hospital of China Medical University between March 2017 to November 2018,BI-RADS final assessments for DBT and ultrasound,combined diagnosis were recorded.Categories 1-4A were clinically considered as benign,and categories 4B-5 were clinically considered as malignant.The diagnostic performance of DBT,US,DBT+US were correlated with final pathologic reports.The primary endpoint was overall diagnostic accuracy determined by area under the receiver operating characteristic curve(AUC).Secondary endpoint included sensitivity and specificity.Result: A total of 242 patients were enrolled in this study.264 lesions were detected,including 128 benign lesions(48.48%)and 136 malignant lesions(51.52%).The area under the ROC curve of DBT,ultrasound and combined diagnosis was 0.801,0.768 and 0.869,respectively.There was significant difference in AUC between combined diagnosis and DBT or ultrasound(P<0.05),there was no significant difference in AUC between DBT and ultrasound(P>0.05).DBT exhibited higher sensitivity(86.03% vs 78.68%;P>0.05)and lower specificity than US(74.22% vs 75.00%;P>0.05).The sensitivity of combined diagnosis for dense breast lesions were higher than that of DBT and ultrasound(94.12% vs 86.03%,78.68%;P<0.05)and the specificity were higher than that of DBT and ultrasound(79.69 vs 74.22%,75.00%;P>0.05).Conclusion: DBT showed similiar diagnostic performance with ultrasound in women with dense breasts.The combined diagnosis was beneficial to the diagnosis of the lesions in dense breasts.