Impact of Addition of Digital Breast Tomosynthesis to Digital Mammography in Lesion Characterization in Breast Cancer Patients

Context Digital breast tomosynthesis (DBT) is a new development in mammography technology which reduces the effect of overlapping tissue. Aims The aim is to interrogate whether addition of DBT to digital mammography (DM) helps in better characterization of mammographic abnormalities in breast cancer patients in general and in different breast compositions. Settings and Design Retrospective, analytical cross-sectional study. Subjects and Methods Mammographic findings in 164 patients with 170 pathologically proven lesions were evaluated by using first DM alone and thereafter with addition of DBT to DM. The perceived utility of adjunct DBT was scored using a rating of 0-2. A score of 0 indicating that DM plus DBT was comparable to DM alone, 1 indicating that DM plus DBT was slightly better, and 2 indicating that DM plus DBT was definitely better. Statistical Analysis McNemar Chi-squares test, Fisher's exact test. Results On DM, 149 lesions were characterized mass with or without calcifications, 18 asymmetries with or without calcifications, 2 as architectural distortion, and 1 as microcalcification alone. Adjunct DBT helped in better morphological characterization of 17 lesions, with revelation of underlying masses in 16 asymmetries and one architectural distortion. Adjunct DBT was perceived to be slightly better than DM alone in 44.7% lesions, and definitely better in 22.9% lesions. Lesions showing score 1 or 2 improvement were significantly higher in heterogeneously and extremely dense breasts (P < 0.001). Conclusions Adjunct DBT improves morphological characterization of lesions in patients with breast cancer. It highlights more suspicious features of lesions that indicate the presence of cancer, particularly in dense breasts.