Breast Cancer Screening with Digital Mammography or Tomosynthesis

Introduction: Digital breast tomosynthesis (DBT) with 3D images might overcome some of the limitations of conventional 2D mammography for breast cancer. A limitation of standard 2D mammography is the superimposition of breast tissue or parenchymal density. This may affect both sensitivity and specificity cancer detection. Also It is well established that false-positive mammography findings are associated with increased short-term anxiety as well as significant cost to the health care system. The purpose of this study was to evaluate the screening outcomes of digital breast tomosynthesis compared with digital mammography (DM) for the subgroup of patients undergoing baseline screening. Objective: To compare the change in diagnostic accuracy of digital mammography and digital breast tomosynthesis in women following routine screening. Materials and methods: In this review the keywords digital mammography, breast tomosynthesis, screening were searched in PubMed and Google scholar. Finally articles from 2015 to 2018 were evaluated. Results: Initial clinical studies of 3D mammography, suggest that addition of 3D to 2D mammography could improve cancer detection and reduce the number of false positives. Digital breast tomosynthesis has the potential to improve the accuracy of mammography by enabling the reader to view x-ray images of the breast tissue as a series of thin reconstructed sections, so overcoming the problem of overlying tissues on conventional two-dimensional images. DBT could increase the efficiency and effectiveness of screening through improvement in both specificity and sensitivity. This review shows that women younger than 50 years who are undergoing baseline screening may benefit more from digital breast tomosynthesis than from digital mammography alone and DBT screening significantly reduces the recall rate for this patients. Conclusion: The addition of Digital breast tomosynthesis increases the accuracy of mammography compared to digital mammography alone in the assessment of screen-detected soft-tissue mammographic abnormalities.

Keywords:

Digital breast tomosynthesis , digital mammography , screening