The aim: Comparing sensitivity and specificity of digital breast tomosynthesis and full-field digital mammography in breast cancer detection associated with four different types of asymmetries according to BI-RADS Atlas. Materials and methods: Study included 201 patients with four types of asymmetries according BI-RADS atlas (asymmetry – 81 (40,3%), focal asymmetry – 82 (40,8%), global asymmetry – 36 (17,9%) and developing asymmetry – 2 (1,0%)) who underwent full-field digital mammography, digital breast tomosynthesis and hand-held full breast ultrasound from January 2017 to June 2018. The general rate of breast cancer for the 201 patients with asymmetries was 8 cases (4,0%) (IBC, n=6 (3,0%); DCIS, n=2 (1,0%) other findings associated with asymmetries were non-malignant, n=10 (5,0%) (sclerosing adenosis, n=5 (2,5%); fibroadenomatosis, n=3 (1,5%); simple cyst, n=1 (0,5%); radial scar associated with papilloma, typical ductal hyperplasia and sclerosing adenosis, n=1 (0,5%). Results: Analysis of the results showed that sensitivity of digital breast tomosynthesis was 75.0% [95% CI, 34.91% to 96.81%] and specificity was 94.8% [95% CI, 90.68% to 97.49%] which was superior to full-field digital mammography sensitivity 50.0% [95% CI, 15.70% to 84.30%] and specificity 91.19% [95% CI, 86.27% to 94.78%] for breast cancer detection associated with different types of asymmetries. Conclusions: Using of digital breast tomosynthesis in assessment of breast asymmetries can improve sensitivity and specificity in breast cancer detection and reduce number of unnecessary biopsies and short-interval follow-up examinations.

Summary. Aim: To evaluate the sensitivity and specificity of digital breast tomosynthesis compared with full-field digital mammography in detection of breast cancer presenting as a mass in women with dense breasts. Маterials and Methods: This study included 347 asymptomatic and symptomatic patients with dense breasts who underwent full-field digital mammography, digital breast tomosynthesis and hand-held full breast ultrasound. 57 core-needle biopsies were performed. Pathology included 31 invasive cancers and 26 non-cancerous lesions. Results: Sensitivity of full-field digital mammography was 61.3% [0.422–0.789] and sensitivity of digital breast tomosynthesis was 77.4% [0.589–0.904]. Specificity of full-field digital mammography was 92.7% [0.893–0.953] that was 2.2% lower than the specificity of digital breast tomosynthesis — 94.9% [0.919–0.971]. Conclusion: Results of our study showed superior sensitivity and specificity of digital breast tomosynthesis compared to full-field digital mammography for detection of malignant masses in women with dense breasts.

The aim: The aim of our study was to determine if digital breast tomosynthesis improves breast cancer detection associated with architectural distortion in comparison with full-field digital mammography in the absence of appropriate history of trauma or surgery. Materials and methods: The overall rate of breast cancer involvement for the 34 patients with architectural distortion was 15 cases (44,1%) (invasive breast cancers, n=12 (36,4%); ductal cancer in situ, n= 3 (8,8%)) other findings associated with architectural distortion were high-risk lesions and benign findings (radial scar, n=5 (14,7%); sclerosing adenosis, n=9 (26,5%); typical lobular hyperplasia, n=3 (8,8%); typical ductal hyperplasia, n=2 cases (5,9%)). Results: Overall of 17/34 (50.0%) architectural distortions were identified at digital breast tomosynthesis that were missed at full-field digital mammography what was statistically significant difference ([95% CI, 2.56–7.45]; p=0.00001). Analysis of the results showed that sensitivity of full-field digital mammography for digital breast tomosynthesis detected breast cancers associated with architectural distortion was 53.3% [95% CI, 26.59% to 78.73%] and specificity was 52.63% [95% CI, 28.86% to 75.55%]. Conclusions: Our study suggests that digital breast tomosynthesis detects more breast cancers represented as architectural distortion which are occult on full-field digital mammography. Presence of microcalcifications within architectural distortion, in the absence of appropriate history of trauma or surgery, has a high likelihood of malignancy and obligatorily requires biopsy.

In this article, in a specific clinical case, the features of the image of secondary lymphoma of the breast with the use of a multimodal clinical-radiological approach were determined and the main literature sources for increasing awareness of this rare but very important pathology are given. Radiologic features of breast lymphomas are non-pathognomonic and may mimic different forms of invasive breast cancer. However, radiologists and clinicians should be aware of this rare pathology to avoid a misinterpretation. The multimodal clinical and radiological approach can be as close as possible to the diagnosis of braest lymphoma, and will pave the way for further diagnostics as biopsy and histopathological evaluation remain the gold-standard for diagnosis. Key words: breast limphoma, digital breast tomosynthesis, full-field digital mammography, breast ultrasound, Selenia Hologic, core needle biopsy.