Three-dimensional tomosynthesis versus two-dimensional mammography in detection and characterization of different breast lesions

Background: Breast cancer is considered the most serious lesion among different breast lesions. Mammography is the corner stone for screening for detection of breast cancer. It has been modified to digital mammography (DM) and then to digital breast tomosynthesis (DBT). Tomosynthesis is an emerging technique for diagnosis and screening of breast lesions. The aim of this study is to interrogate whether the addition of DBT to DM helps in better detection and characterization of different breast lesions. Methods: This is a prospective study carried on 38 female patients according to our inclusion criteria. All patients were evaluated by using DM alone and thereafter with the addition of DBT to DM. Recall rate was calculated, and the imaging findings of each case were correlated with the final diagnosis and follow-up. Results: DM identified 32 lesions while DBT with DM identified 37 lesions. On DM alone, 17 lesions were characterized as masses, 5 as focal asymmetry, 2 as architectural distortion, 7 as microcalcification and 1 as macrocalcification. With the addition of DBT, 27 lesions were characterized as masses, 1 as focal asymmetry, 1 as architectural distortion, 7 as microcalcification and 1 as macrocalcification. So, there were better detection and characterization of lesions with the addition of DBT than DM alone. The sensitivity, specificity, AUC, positive and negative predictive values were significantly higher with the addition of DBT to DM (100%, 90.5%, 0.952, 90% and 100%, respectively) than with DM (77.8%, 80.9%, 0.794, 77.8% and 80.9%, respectively) for all breast lesions. Conclusions: The addition of DBT to DM helps in better detection and characterization of different breast lesions. This leads to early detection of breast cancer, improvement of the performance of radiologists and saving time by reduction of recall rate.