Breast Cancer

, Volume 25, Issue 5, pp 590–596 | Cite as

Improvement in diagnostic performance of breast cancer: comparison between conventional digital mammography alone and conventional mammography plus digital breast tomosynthesis

  • Ryoko Ohashi
  • Michinobu Nagao
  • Izumi Nakamura
  • Takahiro Okamoto
  • Shuji Sakai
Original Article



The aim of this study was to determine if the diagnostic performance of breast lesion examinations could be improved using both digital breast tomosynthesis (DBT) and conventional digital mammography (CDM).


Our institutional review board approved the protocol, and patients were provided the opportunity to opt out of the study. A total of 628 patients aged 22–91 years with abnormal screening results or clinical symptoms were consecutively enrolled between June 2015 and March 2016. All patients underwent DBT and CDM, and 1164 breasts were retrospectively analyzed by three radiologists who interpreted the results based on the Breast Imaging Reporting and Data System. Categories 4 and 5 were considered positive, and pathological results were the gold standard. The diagnostic performance of CDM and CDM plus DBT was compared using the mean areas under the receiver operating characteristic (ROC) curves.


A total of 100 breast cancer cases were identified. The areas under the ROC curves were 0.9160 (95% confidence interval 0.8779–0.9541) for CDM alone and 0.9376 (95% confidence interval 0.9019–0.9733) for CDM plus DBT. The cut-off values for both CDM alone and CDM plus DBT measurements were 4, with sensitivities of 61.0% (61/100) and 83.0% (83/100), respectively, and specificities of 99.1% (1054/1064) and 98.9% (1052/1064), respectively. CDM yielded 39 false-negative diagnoses, while CDM plus DBT identified breast cancer in 22 of those cases (56.4%).


The combination of DBT and CDM for the diagnosis of breast cancer in women with abnormal examination findings or clinical symptoms proved effective and should be used to improve the diagnostic performance of breast cancer examinations.


Breast cancer Conventional digital mammography Digital breast tomosynthesis False negative Screening 



Breast imaging reporting and database system


Conventional digital mammography


Digital breast tomosynthesis


Receiver operating characteristic


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© The Japanese Breast Cancer Society 2018

Authors and Affiliations

  • Ryoko Ohashi
    • 1
  • Michinobu Nagao
    • 1
  • Izumi Nakamura
    • 1
  • Takahiro Okamoto
    • 2
  • Shuji Sakai
    • 1
  1. 1.Department of Diagnostic Imaging and Nuclear MedicineTokyo Women’s Medical UniversityTokyoJapan
  2. 2.Department of Breast and Endocrine SurgeryTokyo Women’s Medical UniversityTokyoJapan

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