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KMID : 0880420230240040274
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Korean Journal of Radiology
2023 Volume.24 No. 4 p.274 ~ p.283
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Digital Breast Tomosynthesis Plus Ultrasound Versus Digital Mammography Plus Ultrasound for Screening Breast Cancer in Women With Dense Breasts
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Ha Su-Min
Yang Seung-Han
Yim Da-Hae
Jang Myoung-Jin
Kwon Bo-Ra
Kim Yong-Guk
Lee Eun-Jae
Park Ji-Won
Moon Woo-Kyung
Chang Jung-Min
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Abstract
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Objective : To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts.
Materials and Methods : A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared.
Results : A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40?78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8?19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7?15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%?34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%?24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%?28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%?18.9%; P < 0.001).
Conclusion : DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.
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KEYWORD
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Breast cancer, Digital breast tomosynthesis, Mammography, Screening, Ultrasound
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