One-view breast tomosynthesis vs two-view mammography: a methodological issue
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Tomosynthesis
Digital Breast Tomosynthesis
Breast Cancer Screening
Digital Mammography
Breast imaging
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Digital Breast Tomosynthesis
Digital Mammography
Breast Cancer Screening
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Abstract Background Tomosynthesis is a recent advancement of full-field digital mammography involves transforming two-dimensional (2D) breast images into three dimensions (3D) images. It reduces the adverse effect of tissue superimposition on conventional 2D- mammography, therefore having high potential enhancing identification and assessment of asymmetric breast densities. The aim of the study was to assess and compare the diagnostic performance of breast ultrasound and 3D digital breast tomosynthesis in the assessment of asymmetric breast densities. Results In the current study, 80 patients with 80 mammographically and/or tomosynthesized breast asymmetries were included. The patients' ages ranged from 30 to 70 years old, with a mean age of 47.2 ± 9.2 SD. Breast ultrasound outperformed digital breast tomosynthesis in terms of diagnostic performance. Tomosynthesis had a sensitivity of 86.4%, specificity of 93.1%, positive predictive value of 82.6%, negative predictive value of 94.7%, and accuracy of 91.3% compared to ultrasounds' sensitivity of 100.00%, specificity of 93.1%, positive predictive value of 84.6%, negative predictive value of 100.00%, and accuracy of 95%. Conclusions Incorporating ultrasonography in the assessment of asymmetric breast densities outperformed tomosynthesis and shown to be more precise in characterisation of lesions underlying asymmetric breast density.
Tomosynthesis
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Breast ultrasound
Breast imaging
Breast density
Digital Mammography
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Most breast imaging programs have replaced film-screen mammography systems with digital mammography. Other breast imaging methods, such as digital breast tomosynthesis, complement the tools available for screening and diagnosis of breast cancer. This article examines digital mammography, other digital breast imaging modalities, and the effects of these technologies on practice, quality, efficiency, and the technologist's role in patient care.
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Breast Cancer Screening
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The best tool to detect breast cancer (BC) is `screening`. Earlier screening improves prognosis and better treatment outcomes. Screening is basically looking for different signs before the appearance of actual symptoms. The process of screening specifically used for BC is known as mammography.
Mammography is an explicit kind of imaging system that uses X-Rays (low dose) to ascertain cancer in breasts. This diagnostic procedure is in practice since the past 30 years but in the past 15 years, there is an improved set of techniques being introduced resulting in better results. Recently, three major diagnostic procedures for breast cancer which are in vogue include digital mammography, computer-aided testing and tomosynthesis. Out of these 3 diagnostic tools, tomosynthesis, furthermore branded as three-dimensional (3-D) mammography and digital tomosynthesis, is the supreme and innovative system of breast imaging where numerous pictures of the breast from diverse angles are taken and remodeled ("synthesized") resulting in formation of a three-dimensional group of images. That is why, 3-D imaging technique is alike computed tomography imaging system in which a sequences of thin "slices" are gathered to formulate a 3-D reformation of the body.
Even though the strength of radiation for few tomosynthesis systems is higher to some extent as compared to power of the dosage used in typical mammography, but as long as it is in the predefined radiation limit approved by FDA it`s not harmful. Some of the systems have doses comparable to conventional mammography. Some previous studies on large populations have proved that breast screening with tomosynthesis have resulted in enhanced the rate of detection of breast cancer detection rates and it has also decreased the chances of recalls, especially at occasions where females are called back for screening for added testing because of a possibly uncharacteristic finding.
Tomosynthesis has an edge on other diagnostic procedures as it may help in prior recognition of cancerous lesions that may be not be revealed on a conventional mammogram, it also eradicates the need for small number of preventable biopsies or supplementary testing and increases the probability of detection of several breast tumors. It also provides stronger imagining of irregularities within condensed breast tissue and greater precision in pinpointing the location, size and shape of breast anomalies.
Women should at least get a standard mammogram once a year beginning at age 40. The major risk factors for BC development are old age, inactivity, reproductive history, genetic mutations, family history of ovarian or BC, being overweight or obese after menopause, history of administration of hormones. Also, if someone, have had radiation treatment to the chest in the past, it’s highly recommended that such women should have annual mammograms at a younger age (often beginning around age 30).
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Breast cancer screening programs using mammography proved their value in detecting breast cancer at early stages and, consequently, reducing the mortality from this disease.
Due to the technological progress, the screening programs have shifted from screen-film mammography to digital mammography and nowadays digital breast tomosynthesis became the focus of breast imaging research. Using tomosynthesis in screening increases cancer detection rates and decreases recall and false-positive rates, thus improving the effectiveness of breast cancer screening programs, with positive consequences on health care costs and on patient psychology.
More long-term follow-up data must be collected for assessing absolute sensitivity and specificity of digital breast tomosynthesis, together with efforts for addressing the limitations of the method.
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Innovation in breast imaging techniques is leading to better breast cancer detection. Concurrently, breast cancer screening recommendations are changing, and breast density is becoming a more significant factor in breast cancer screening. Digital mammography has become the preferred screening method, with more breast imaging centers including the use of digital breast tomosynthesis (DBT). The technology's role in breast imaging has not been clarified fully, and several clinical trials are addressing DBT. This article presents research findings on digital mammography and DBT and explores the future role of 3-D breast imaging.
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