Comparison of Digital Mammography Alone and Digital Mammography Plus Tomosynthesis in a Population-based Screening Program

Skaane, Per; Bandos, Andriy I.; Gullien, Randi; Eben, Ellen B.; Ekseth, Ulrika; Haakenaasen, Unni; Izadi, Mina; Jebsen, Ingvild N.; Jahr, Gunnar; Krager, Mona; Niklason, Loren T.; Hofvind, Solveig; Gur, David

doi:10.1148/radiol.12121373

Cited by 891 publications

(640 citation statements)

References 38 publications

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“…Newer studies point out that two DBT planes are not always necessary if MG has been performed in two planes [9]. Still DBT helps to improve diagnostic accuracy of detection of breast lesions compared to mammography alone [10,11].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the extent of microcalcifications to predict the size of a ductal carcinoma in situ: comparison between tomosynthesis and conventional mammography

Berger

Schwizer

Varga³

et al. 2016

Clinical Imaging

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OBJECTIVES The objective was to determine if digital tomosynthesis of the breast (DBT) assesses the extension of ductal carcinoma in situ (DCIS) with higher precision than mammography (MG). MATERIAL AND METHODS The local ethics committee approved this retrospective study including 26 patients with DCIS, which were rated by three radiologists. Statistics were performed using intraclass correlation (ICC) for interreader agreement and the Pearson correlation for correlation of MG and DBT. Standard of reference was the histologic extension. RESULTS The ICC was excellent. Correlation between MG and histology was 0.879 (P<.01) and for DBT and histology was 0.914 (P<.01). CONCLUSION DBT provides a slightly better estimation of the size of a DCIS than MG. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT Abstract ObjectivesIf digital tomosynthesis of the breast (DBT) assesses the extension of Ductal carcinoma in situ (DCIS) with higher precision than mammography (MG). Material and MethodsRetrospective and local ethic committee approved study including 26 DCIS, which were rated by three radiologists. Statistics were performed using intraclass correlation (ICC) for interreader agreement and the Pearson's Correlation for correlation of MG and DBT. Standard of reference was the histologic extension. ResultsThe ICC was excellent. Correlation between MG and histology was 0.879(p<0.01) and for DBT and histology 0.914(p<0.01). ConclusionDBT provides a slightly better estimation of the size of a DCIS than MG.

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Section: Introductionmentioning

confidence: 99%

Assessment of the extent of microcalcifications to predict the size of a ductal carcinoma in situ: comparison between tomosynthesis and conventional mammography

Berger

Schwizer

Varga³

et al. 2016

Clinical Imaging

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“…As expected, the greatest gains in sensitivity were observed for younger women and those with heterogeneously dense breasts [36,37], but interestingly, there was no significant increase in cancer detection in those with extremely dense breasts [37]. DBT is currently being used in Australia as a diagnostic tool, but there is increasing evidence to suggest that it may be beneficial as a screening tool [33][34][35][36]. However, it is common practice to use DBT in conjunction with, rather than instead of, digital mammography, which results in a total examination dose approximately 2-3 times that of digital mammography alone.…”

Section: Advances In Technologymentioning

confidence: 56%

“…The main advantage of DBT is that it significantly reduces the effects of superimposition, thereby enabling visualisation of lesions that would be masked by over-or under-lying tissue and distinguishing real lesions from those mimicked by superimposition of normal structures [29]. A number of studies on large screening populations showed an increase in overall cancer detection rate and a reduction in recall rate when using DBT in addition to 2D digital mammography, compared to using 2D digital mammography alone [33][34][35][36]. As expected, the greatest gains in sensitivity were observed for younger women and those with heterogeneously dense breasts [36,37], but interestingly, there was no significant increase in cancer detection in those with extremely dense breasts [37].…”

Section: Advances In Technologymentioning

confidence: 99%

How many physicists does it take to test a mammography unit?

Diffey¹

2017

Australas Phys Eng Sci Med

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Mammography is defined as the X-ray examination of the breast. It is just one of the modalities used for breast imaging; ultrasound and magnetic resonance imaging (MRI) are incredibly valuable adjunct techniques and newer technologies are gradually being adopted, such as molecular breast imaging and dedicated breast computed tomography. Inevitably, we tend to associate the term breast imaging with breast screening. Although breast screening has its critics [3], there can be no doubt that breast cancer is a major health burden on a global scale; it is the second most common cancer in the world and is responsible for more female deaths than any other cancer type [4]. Within Australia, 1 in 8 women will be diagnosed with breast cancer by the age of 85 [5]. However, it is reassuring to note that mortality rates are decreasing despite the fact that incidence rates continue to rise and the diagnosis rates in young women are increasing [6].Mammography is considered to be the gold standard for breast screening, having an overall sensitivity of about 85% and specificity of 90% [7] in women aged 50-70. Breast imaging is challenging since it is necessary to detect and classify pathological details (microcalcifications and masses) against a background of fibrous tissue, which can vary considerably in radiological appearance depending on breast thickness and composition.Microcalcifications have a relatively high atomic number and density and hence high inherent and subject contrast. Unfortunately they are generally very small in size, ranging from 10 µm through to several mm [8]. Although masses are of moderate size (5-10 mm), detection of carcinoma is difficult since malignant tissue has negligible physical density difference from fibrous breast tissue, a similar attenuation coefficient and therefore low inherent contrast I'm sorry to lure you in with a joke for which I don't have a punchline; the answer is just one, yet there are 95 physicists in Australia and New Zealand who hold ACPSEM Certification in Mammography Equipment Testing [1]. To put this into perspective, there are only 41 medical physicists who hold ACPSEM Certification in Radiology [2].This raises the questions of why mammography is the only radiology modality to have its own certification process and why there is so much demand for this qualification. Having spent 12 years specialising in mammography physics, I'll attempt to answer these questions and look at how mammographic technology has changed over the years and how this has impacted the role of the medical physicist.

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“…Newer technology such as digital breast tomosynthesis may provide higher sensitivity and increase cancer detection rate compared with digital mammography because of its ability to remove overlapping glandular tissue, the main reason for both false-positive and -negative results with traditional mammography. [10][11][12][13][14] Although tomosynthesis requires breast compression similar to mammogram, the compression force may be lower without affecting image quality. 14 Further studies would be helpful to determine whether the benefits of the MammoPad used by Chan et al 8 could have further benefit in tomosynthesis.…”

Section: Mammography For Breast Cancer Detection In Hong Kongmentioning

confidence: 99%

Mammography for breast cancer detection in Hong Kong

Wong

Lui²

2016

Hong Kong Med J

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Comparison of Digital Mammography Alone and Digital Mammography Plus Tomosynthesis in a Population-based Screening Program

Abstract: The use of mammography plus tomosynthesis in a screening environment resulted in a significantly higher cancer detection rate and enabled the detection of more invasive cancers. Clinical trial registration no. NCT01248546.

Cited by 891 publications

References 38 publications

Assessment of the extent of microcalcifications to predict the size of a ductal carcinoma in situ: comparison between tomosynthesis and conventional mammography

Assessment of the extent of microcalcifications to predict the size of a ductal carcinoma in situ: comparison between tomosynthesis and conventional mammography

How many physicists does it take to test a mammography unit?

Mammography for breast cancer detection in Hong Kong

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