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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.

“Young women,” defined as women younger than 40 years at breast cancer diagnosis, represent approximately 7% of all women diagnosed with breast cancer in developed countries. Breast cancer is the leading cause of cancer-related death in young women. It constitutes more than 12,150 newly diagnosed patients every year in the United States. Young women have specific issues including those related to fertility, cancer genetics, and psychosocial concerns, and often need a different approach than do older women.1 Although breast cancer in older women is detected most commonly by mammographic screening, breast cancer in young women is diagnosed more often by clinical symptoms. Delayed diagnosis in this age group is common due to lack of awareness in women and physicians.2 The radiologist must have an appropriate level of suspicion while evaluating young women so as not to miss breast cancer.

e13601 Background: Since 2011 breast cancer (BC) has been the most common cancer in the Republic of Kazakhstan (RK) with the incidence of 43 per 100,000, and the third most common cause for cancer deaths with 9.4 deaths per 100,000 in 2019. Nationwide population-based screening program was implemented in the RK in 2008 inviting women aged 50–60 years every 2 years, with the subsequent expansion of the target group age to 40-70 years in 2018. The majority of screening mammography units was screen-film units at a time of program’s initiation. Gradual conversion to digital mammography (DM) has begun in 2014. This paper examines the impact of digital technologies on BC screening results on the example of the largest city in the RK - Almaty. Methods: We analyzed BC screening indicators such as incidence, mortality, proportion of early stage cancers, cancer detection rate. In order to assess the influence of transition to DM we divided the studied period to two stages: stage A (2008-2013)- when screen-film mammography (SFM) was widely used, and stage B (2014-2019)- when DM became prevalent in screening. Results: 598,058 women underwent BC screening from 2008 to 2019 in Almaty, 969 cancers were detected. At a time of program introduction in 2008 all 10 units used for screening were SFM units. The number of SFM units steadily increased from 10 in 2008 to 19 in 2014 and to 30 in 2019. Proportion of DM units concomitantly grew from 0% in 2008 to 47% in 2014 and to 83% in 2019. During the stage A 282 BC cases were detected (cancer detection rate 1 per 100,000 investigations). During the period B 687 BC cases were identified (cancer detection rate 2 per 100,000 investigations). Proportion of early stage cancers (0-I stage) rose from 26.7% in stage A to 41.0% in stage B. Widespread implementation of screening in 2008 led to a steady increase in BC incidence from 51 per 100,000 in 2008 to 63 per 100,000 in 2014. A noticeable decline in BC incidence has been evident since 2015 following 7 years of BC screening with incidence rate as low as 47.2 per 100,000 in 2019. Proportion of early stage BC among all newly diagnosed cases increased from 73.6% in 2008 to 86.6% in 2019. The average proportion of early stage BC was 77.5% for period A compared to 85,9% for stage B. Mortality rate was also affected by screening- it dropped by 38% from 20.6 per 100,000 in 2008 to 12.8 per 100,000 in 2019. Conclusions: BC state in Almaty reflects the general situation with BC in the whole country. Mammographic screening positively affected both BC incidence and mortality in Almaty. Increased utilization of digital technologies in screening resulted in rise in the proportion of early (0-I) stage BC by 21.4% and in the proportion of I-II stage BC by 13%. We suggest that, based on these results, further digitalization of mammographic screening should be strongly advised and digital to screen-film units ratio should be one of the main indicators for BC screening quality audit.

Relevance: Breast cancer is the most common malignant neoplasm among wom-en in our country. Mammography is currently the method of choice in breast can-cer diagnostics. However, it has limitations associated with the imposition of breast tissue layers, which makes it difficult to identify lesions and leads to a mis-diagnosis. Breast tomosynthesis is a tomographic technique in which the effect of tissue superimposition is significantly reduced due to layer-by-layer scanning. The purpose of this study was to review the capacity of tomosynthesis in the di-agnosis of breast cancer. Results: The combination of tomosynthesis with a synthesized image is the best technology for screening because it offers the best combination of efficiency and radiation dose. Advantages include greater diagnostic accuracy due to both in-creased sensitivity and specificity, and a significantly less need for additional mammography projections (targeted mammography, targeted mammography with magnification). Conclusions: Tomosynthesis as a diagnostic method significantly exceeds the method of mammography. The higher informative value of the results provided by tomosynthesis reduces the frequency of false-negative and false-positive radio-logical conclusions.