The role of tomosynthesis in evaluation of suspicious solid breast lesion in comparison with mammography and ultrasonography in patients over 30 years old

Abstract

Background Digital breast tomosynthesis (DBT) has been developed to improve the detection and characterization of breast lesions and to overcome the limitations of digital mammography. The aim of this work was to highlight the value of DBT in evaluation of suspicious solid breast lesions in comparison with mammography and ultrasonography in patients over 30 years old. Patients and methods This prospective study included a total of 50 females who had 54 suspicious solid breast lesions, and all patients were evaluated by mammography, tomosynthesis, and ultrasound. Their age ranging from 30 to 90 years old with mean age±SD was 58.8±12.7 years. All radiological findings were compared with the final histopathology diagnosis, which was the gold standard for our study. Results The sensitivity of tomosynthesis was 96%, the specificity was 75%, the positive predictive value (PPV) was 98%, the negative predictive value (NPV) was 60%, and the accuracy was 94%. While the sensitivity of digital mammography was 92%, the specificity was 50%, the PPV was 95%, the NPV was 33%, and the accuracy was 88%. Breast ultrasound showed the highest sensitivity in our study where the sensitivity of ultrasound was 98%, the specificity was 100%, the PPV was 100%, the NPV was 80%, and the accuracy was 98%. Conclusion DBT technique can improve the clinical performance of mammography by increasing the sensitivity and specificity. It overcomes the limitation of mammography caused by tissue overlapping. Thus, it can provide better tissue visualization by its characteristic capability of producing three-dimensional nonoverlapped tissue information.