These data show that sonography is the more accurate imaging test in women 45 years old or younger who present with breast symptoms and may be an appropriate initial imaging examination.

No abstract

Our findings support the provision of clinical information relating to patients' presentation to radiologists reporting diagnostic mammography.

Breast ultrasound is generally interpreted with knowledge of the mammographic examination. This study examined the influence of knowledge of mammography findings on the accuracy of ultrasound in women with breast symptoms. Subjects were sampled from all women 25-55 years of age consecutively attending a breast clinic. This included all 240 women shown to have breast cancer and 240 age-matched women shown not to have cancer. Ultrasound films were prospectively reviewed and reported by two radiologists independent of each other and in a blinded manner. A two-phase design was used. In the first phase, the radiologists provided an opinion on the ultrasound films. In the second phase, the ultrasound films were reread with consideration of the corresponding mammographic examination. The accuracy of reading the ultrasound with and without knowledge of the findings on mammography was compared using sensitivity and specificity, and receiver operating characteristics (ROC) curves. Reporting the ultrasound with knowledge of mammography (compared to without mammography) improved sensitivity and reduced specificity for both radiologists. For one reader, sensitivity increased from 77.5% to 86.7% (p = 0.0002) and specificity decreased from 89.7% to 85.4% (p = 0.04). For the other reader, sensitivity increased from 81.3% to 87.5% (p = 0.0023) and specificity decreased from 87.1% to 85.0% (p = 0.27). ROC curves for both radiologists showed that reporting ultrasound with knowledge of mammography resulted in small (about 3%), but significant improvement in the area under the ROC curve. Our study indicates that knowledge of the findings of mammography improves the interpretation of breast ultrasound in symptomatic women.

Mammography has long been considered as the primary technique in breast cancer detection and assessment. Despite low specificity, mammography has been preferred over other contemporary techniques such as magnetic resonance imaging (MRI), computed tomography (CT) and ultrasonography (US) due to superior sensitivity and significant health economic benefits. The development of a new technique, a limited angle cone beam pseudo‐three‐dimensional tomosynthesis, digital breast tomosynthesis (DBT), has gained momentum. Several preliminary studies and ongoing trials are showing evidence of the benefits of DBT in improving lesion visibility, accuracy of cancer detection and observer performance. This raises the possibility of adoption of DBT in the breast cancer assessment clinic, wherein confirming or dismissing the presence of malignancy (at the potential site identified during screening) is of utmost importance. Identification of suspected malignancy in terms of lesion characteristics and location is also essential in assessment. In this literature review, we evaluate the role of DBT for use in breast cancer assessment and its future in biopsy.