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Architectural distortion outcome: digital breast tomosynthesis-detected versus digital mammography-detected

  • Breast Radiology
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Abstract

Objectives

To compare the outcome for DBT-detected and DM-detected suspicious AD, to evaluate the risk of malignancy and if is affected by the US or MRI imaging correlation.

Methods

All cases with suspicious AD (ultimately assigned BI-RADS 4 or 5 categories) were retrospectively included. Two radiologists independently reviewed DM and DBT images in two sessions for detection (DM vs. DBT). US and MRI imaging correlation findings were recorded. Pathologic results were compared between DBT-detected and DM-detected AD.

Results

Among 137 detected ADs, 103 (75.2%) were DM-detected, and 34 (24.8%) were only DBT-detected (p = 0.01).

The malignancy rate was lower for DBT-detected than DM-detected AD (14.7% vs. 45.6%) (p = 0.01). Malignancy rate was higher with US-positive than US-negative correlation at DM-detected AD (49.4% vs. 27.8%) (p = 0.01). Malignancy rate was not different for DBT-detected AD with (16.7%) or without (12.5%) sonographic correlation. NPV based on radiologists’ level of suspicion was high (86.2%–97.2%) but not sufficient enough to forgo biopsy.

Of 34 sonographically occult ADs, a positive-MRI correlation was identified in 19 (55.9%) ADs (7 were malignant, 12 were benign). A negative-MRI correlation was identified in 15 (44.1%) ADs; all had a benign outcome (p = 0.01).

Conclusions

DBT-detected AD is less likely to represent malignancy than does DM-detected; however, the risk of malignancy is not low enough to forgo biopsy. MRI-negative correlation in sonographically occult AD was significantly associated with benign outcomes and can avoid unnecessary interventions.

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Abbreviations

DBT:

Digital breast tomosynthesis

DM:

Digital mammography

AD:

Architectural distortion

BI-RADS:

The Breast Imaging Reporting and Data System Lexicon

DCIS:

Ductal carcinoma in situ

US:

Ultrasound

MRI:

Magnetic resonance imaging

PPV:

Positive predictive value

NPV:

Negative predictive value

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Correspondence to Shimaa Abdalla Ahmed.

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The scientific guarantor of this publication is DR. Shimaa Abdalla Ahmed. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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Ahmed, S.A., Samy, M., Ali, A.M. et al. Architectural distortion outcome: digital breast tomosynthesis-detected versus digital mammography-detected. Radiol med 127, 30–38 (2022). https://doi.org/10.1007/s11547-021-01419-8

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  • DOI: https://doi.org/10.1007/s11547-021-01419-8

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