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Abstract

BACKGROUND: Breast cancer is comments type of cancer in women, and the second leading cause of death worldwide. Mammography had been the cornerstone for breast cancer diagnosis throughout the years.                     Digital breast tomosynthesis had been developed as an advanced method for early diagnosing a breast lesion and found to have promising results in both screening and diagnostic measures more importantly in dense and previously treated breasts. OBJECTIVE: To evaluate digital breast tomosynthesis (DBT) compared to digital mammography for the detection of different breast lesions and interpretations of BIRADS IV and V scoring in different breast densities. PATIENTS AND METHODS: A prospective cohort conducted at Oncology teaching hospital in Medical City teaching complex in Baghdad for the period of 8 months from March 2021 to November 2021, included 101 suspicious breast lesions (BIRADS IV and V) was undergone Digital mammography and Digital Breast tomosynthesis, and diagnosis confirmed with FNA cytology and/or US guided core needle biopsy. Statistical analysis was done using IBM SPSS software version 25, statistical comparisons were performed using the Chi-square test or fisher’s exact test. Significance was defined as a P value less than 0.05. RESULTS: The results obtained from the study regarding the diagnostic performance of each modality showed that higher sensitivity for DBT 100% in comparison to DM 69.2%, however the specificity for DBT was not measured because of absence of true negative cases as the result of the selection criteria,                       the accuracy of DBT was higher for ACR a (100% vs 72.7%) and c (54.5 vs 45.4%) than mammography, However, they were the same for ACR b, for ACR d we have only 2 cases. Additionally, we found that change in BI-RADS scoring with BDT was 12/24 (50%) in dense breast categories (ACR c and d) while in fatty and scattered fibroglandular breasts (ACR a and b), it was 44/77 (57%). CONCLUSION: These findings indicate that tomosynthesis is superior to mammography in terms of sensitivity at all breast densities, but notably at greater densities. It is advantageous because, unlike mammography, which produces two-dimensional images, it eliminates obscuring breast tissue and provides a higher resolution of the internal breast structures. And this will result in a decrease in false positive results, recalls, and special mammographic views, as well as a decrease in radiation exposure and costs.    

DOI

10.52573/ipmj.2024.184965

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