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Published in: Indian Journal of Surgical Oncology 2/2021

01-06-2021 | Mammography | Review Article

Digital Breast Tomosynthesis: an Overview

Authors: Ekta Dhamija, Malvika Gulati, S. V. S. Deo, Ajay Gogia, Smriti Hari

Published in: Indian Journal of Surgical Oncology | Issue 2/2021

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Abstract

Breast cancer is emerging as the most common malignancy in Indian women. Mammography is one of the few screening modalities available to the modern world that has proved itself of much use by aiding early detection and treatment of non-palpable, node-negative breast cancers. However, due to its two-dimensional nature, many cases of malignancies are still missed, to be detected at a later date or by an alternate modality. In 2011, FDA approved the supplemental use of digital breast tomosynthesis (DBT) in screening and diagnostic set ups. The acquisition of multiple low-dose projection images of the compressed parenchyma provided a ‘third’ dimension to the mammogram whereby the breast tissue could be seen layer by layer on the workstation. It improves cancer detection rate, and reduces recall rate and false-positive findings by improving lesion characterization. The current review discusses the principle of DBT with a comprehensive study of the literature.
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Literature
6.
go back to reference Tabár L, Yen AM-F, Wu WY-Y, Chen SLS, Chiu SYH, Fann JCY, Ku MMS, Smith RA, Duffy SW, Chen THH (2015) Insights from the breast cancer screening trials: how screening affects the natural history of breast cancer and implications for evaluating service screening programs. Breast J 21:13–20. https://doi.org/10.1111/tbj.12354CrossRefPubMed Tabár L, Yen AM-F, Wu WY-Y, Chen SLS, Chiu SYH, Fann JCY, Ku MMS, Smith RA, Duffy SW, Chen THH (2015) Insights from the breast cancer screening trials: how screening affects the natural history of breast cancer and implications for evaluating service screening programs. Breast J 21:13–20. https://​doi.​org/​10.​1111/​tbj.​12354CrossRefPubMed
9.
go back to reference Lee CH, Dershaw DD, Kopans D, Evans P, Monsees B, Monticciolo D, Brenner RJ, Bassett L, Berg W, Feig S, Hendrick E, Mendelson E, D'Orsi C, Sickles E, Burhenne LW (2010) Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol 7:18–27. https://doi.org/10.1016/j.jacr.2009.09.022CrossRefPubMed Lee CH, Dershaw DD, Kopans D, Evans P, Monsees B, Monticciolo D, Brenner RJ, Bassett L, Berg W, Feig S, Hendrick E, Mendelson E, D'Orsi C, Sickles E, Burhenne LW (2010) Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol 7:18–27. https://​doi.​org/​10.​1016/​j.​jacr.​2009.​09.​022CrossRefPubMed
10.
go back to reference Schünemann HJ, Lerda D, Quinn C, Follmann M, Alonso-Coello P, Rossi PG, Lebeau A, Nyström L, Broeders M, Ioannidou-Mouzaka L, Duffy SW, Borisch B, Fitzpatrick P, Hofvind S, Castells X, Giordano L, Canelo-Aybar C, Warman S, Mansel R, Sardanelli F, Parmelli E, Gräwingholt A, Saz-Parkinson Z, for the European Commission Initiative on Breast Cancer (ECIBC) Contributor Group (2020) Breast cancer screening and diagnosis: a synopsis of the European Breast Guidelines. Ann Intern Med 172:46–56. https://doi.org/10.7326/M19-2125CrossRefPubMed Schünemann HJ, Lerda D, Quinn C, Follmann M, Alonso-Coello P, Rossi PG, Lebeau A, Nyström L, Broeders M, Ioannidou-Mouzaka L, Duffy SW, Borisch B, Fitzpatrick P, Hofvind S, Castells X, Giordano L, Canelo-Aybar C, Warman S, Mansel R, Sardanelli F, Parmelli E, Gräwingholt A, Saz-Parkinson Z, for the European Commission Initiative on Breast Cancer (ECIBC) Contributor Group (2020) Breast cancer screening and diagnosis: a synopsis of the European Breast Guidelines. Ann Intern Med 172:46–56. https://​doi.​org/​10.​7326/​M19-2125CrossRefPubMed
12.
go back to reference Porter GJR, Evans AJ, Cornford EJ, Burrell HC, James JJ, Lee AHS, Chakrabarti J (2007) Influence of mammographic parenchymal pattern in screening-detected and interval invasive breast cancers on pathologic features, mammographic features, and patient survival. Am J Roentgenol 188:676–683. https://doi.org/10.2214/AJR.05.1950CrossRef Porter GJR, Evans AJ, Cornford EJ, Burrell HC, James JJ, Lee AHS, Chakrabarti J (2007) Influence of mammographic parenchymal pattern in screening-detected and interval invasive breast cancers on pathologic features, mammographic features, and patient survival. Am J Roentgenol 188:676–683. https://​doi.​org/​10.​2214/​AJR.​05.​1950CrossRef
21.
go back to reference Lee CH, Destounis SV, Friedewald SM, Newell MS (2013) Digital breast tomosynthesis (DBT) guidance (a supplement to ACR BI-RADS mammography 2013). American College of Radiology, Reston Lee CH, Destounis SV, Friedewald SM, Newell MS (2013) Digital breast tomosynthesis (DBT) guidance (a supplement to ACR BI-RADS mammography 2013). American College of Radiology, Reston
22.
23.
go back to reference Skaane P, Bandos AI, Gullien R, Eben EB, Ekseth U, Haakenaasen U, Izadi M, Jebsen IN, Jahr G, Krager M, Hofvind S (2013) Prospective trial comparing full-field digital mammography (FFDM) versus combined FFDM and tomosynthesis in a population-based screening programme using independent double reading with arbitration. Eur Radiol 23:2061–2071. https://doi.org/10.1007/s00330-013-2820-3CrossRefPubMedPubMedCentral Skaane P, Bandos AI, Gullien R, Eben EB, Ekseth U, Haakenaasen U, Izadi M, Jebsen IN, Jahr G, Krager M, Hofvind S (2013) Prospective trial comparing full-field digital mammography (FFDM) versus combined FFDM and tomosynthesis in a population-based screening programme using independent double reading with arbitration. Eur Radiol 23:2061–2071. https://​doi.​org/​10.​1007/​s00330-013-2820-3CrossRefPubMedPubMedCentral
24.
go back to reference Caumo F, Bernardi D, Ciatto S, Macaskill P, Pellegrini M, Brunelli S, Tuttobene P, Bricolo P, Fantò C, Valentini M, Montemezzi S, Houssami N (2014) Incremental effect from integrating 3D-mammography (tomosynthesis) with 2D-mammography: increased breast cancer detection evident for screening centres in a population-based trial. Breast 23:76–80. https://doi.org/10.1016/j.breast.2013.11.006CrossRefPubMed Caumo F, Bernardi D, Ciatto S, Macaskill P, Pellegrini M, Brunelli S, Tuttobene P, Bricolo P, Fantò C, Valentini M, Montemezzi S, Houssami N (2014) Incremental effect from integrating 3D-mammography (tomosynthesis) with 2D-mammography: increased breast cancer detection evident for screening centres in a population-based trial. Breast 23:76–80. https://​doi.​org/​10.​1016/​j.​breast.​2013.​11.​006CrossRefPubMed
25.
go back to reference Bernardi D, Caumo F, Macaskill P, Ciatto S, Pellegrini M, Brunelli S, Tuttobene P, Bricolo P, Fantò C, Valentini M, Montemezzi S, Houssami N (2014) Effect of integrating 3D-mammography (digital breast tomosynthesis) with 2D-mammography on radiologists’ true-positive and false-positive detection in a population breast screening trial. Eur J Cancer 50:1232–1238. https://doi.org/10.1016/j.ejca.2014.02.004CrossRefPubMed Bernardi D, Caumo F, Macaskill P, Ciatto S, Pellegrini M, Brunelli S, Tuttobene P, Bricolo P, Fantò C, Valentini M, Montemezzi S, Houssami N (2014) Effect of integrating 3D-mammography (digital breast tomosynthesis) with 2D-mammography on radiologists’ true-positive and false-positive detection in a population breast screening trial. Eur J Cancer 50:1232–1238. https://​doi.​org/​10.​1016/​j.​ejca.​2014.​02.​004CrossRefPubMed
26.
go back to reference Ciatto S, Houssami N, Bernardi D, Caumo F, Pellegrini M, Brunelli S, Tuttobene P, Bricolo P, Fantò C, Valentini M, Montemezzi S, Macaskill P (2013) Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol 14:583–589. https://doi.org/10.1016/S1470-2045(13)70134-7CrossRefPubMed Ciatto S, Houssami N, Bernardi D, Caumo F, Pellegrini M, Brunelli S, Tuttobene P, Bricolo P, Fantò C, Valentini M, Montemezzi S, Macaskill P (2013) Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study. Lancet Oncol 14:583–589. https://​doi.​org/​10.​1016/​S1470-2045(13)70134-7CrossRefPubMed
29.
go back to reference Rafferty EA, Park JM, Philpotts LE, Poplack SP, Sumkin JH, Halpern EF, Niklason LT (2013) Assessing radiologist performance using combined digital mammography and breast tomosynthesis compared with digital mammography alone: results of a multicenter, multireader trial. Radiology 266:104–113. https://doi.org/10.1148/radiol.12120674CrossRefPubMed Rafferty EA, Park JM, Philpotts LE, Poplack SP, Sumkin JH, Halpern EF, Niklason LT (2013) Assessing radiologist performance using combined digital mammography and breast tomosynthesis compared with digital mammography alone: results of a multicenter, multireader trial. Radiology 266:104–113. https://​doi.​org/​10.​1148/​radiol.​12120674CrossRefPubMed
32.
37.
go back to reference Zackrisson S, Lång K, Rosso A, Johnson K, Dustler M, Förnvik D, Förnvik H, Sartor H, Timberg P, Tingberg A, Andersson I (2018) One-view breast tomosynthesis versus two-view mammography in the Malmö Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol 19:1493–1503. https://doi.org/10.1016/S1470-2045(18)30521-7CrossRefPubMed Zackrisson S, Lång K, Rosso A, Johnson K, Dustler M, Förnvik D, Förnvik H, Sartor H, Timberg P, Tingberg A, Andersson I (2018) One-view breast tomosynthesis versus two-view mammography in the Malmö Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol 19:1493–1503. https://​doi.​org/​10.​1016/​S1470-2045(18)30521-7CrossRefPubMed
42.
go back to reference Philpotts LE, Kalra VB, Crenshaw J, Butler RS (2013) How tomosynthesis optimizes patient work-up, throughput, and resource utilization [abstr]. In: Radiological Society of North America Scientific Assembly and Annual Meeting Program. Oak Brook, Ill: Radiological Society of North America, 191 Philpotts LE, Kalra VB, Crenshaw J, Butler RS (2013) How tomosynthesis optimizes patient work-up, throughput, and resource utilization [abstr]. In: Radiological Society of North America Scientific Assembly and Annual Meeting Program. Oak Brook, Ill: Radiological Society of North America, 191
43.
go back to reference Roth RG, Maidment ADA, Weinstein SP, et al Digital breast tomosynthesis: lessons learned from early clinical implementation. 34:15 Roth RG, Maidment ADA, Weinstein SP, et al Digital breast tomosynthesis: lessons learned from early clinical implementation. 34:15
44.
go back to reference Patel BK, Covington M, Pizzitola VJ, Lorans R, Giurescu M, Eversman W, Lewin J (2018) Initial experience of tomosynthesis-guided vacuum-assisted biopsies of tomosynthesis-detected (2D mammography and ultrasound occult) architectural distortions. Am J Roentgenol 210:1395–1400. https://doi.org/10.2214/AJR.17.18802CrossRef Patel BK, Covington M, Pizzitola VJ, Lorans R, Giurescu M, Eversman W, Lewin J (2018) Initial experience of tomosynthesis-guided vacuum-assisted biopsies of tomosynthesis-detected (2D mammography and ultrasound occult) architectural distortions. Am J Roentgenol 210:1395–1400. https://​doi.​org/​10.​2214/​AJR.​17.​18802CrossRef
50.
54.
60.
go back to reference Tagliafico A, Mariscotti G, Durando M, Stevanin C, Tagliafico G, Martino L, Bignotti B, Calabrese M, Houssami N (2015) Characterisation of microcalcification clusters on 2D digital mammography (FFDM) and digital breast tomosynthesis (DBT): does DBT underestimate microcalcification clusters? Results of a multicentre study. Eur Radiol 25:9–14. https://doi.org/10.1007/s00330-014-3402-8CrossRefPubMed Tagliafico A, Mariscotti G, Durando M, Stevanin C, Tagliafico G, Martino L, Bignotti B, Calabrese M, Houssami N (2015) Characterisation of microcalcification clusters on 2D digital mammography (FFDM) and digital breast tomosynthesis (DBT): does DBT underestimate microcalcification clusters? Results of a multicentre study. Eur Radiol 25:9–14. https://​doi.​org/​10.​1007/​s00330-014-3402-8CrossRefPubMed
61.
go back to reference Spangler ML, Zuley ML, Sumkin JH, Abrams G, Ganott MA, Hakim C, Perrin R, Chough DM, Shah R, Gur D (2011) Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. Am J Roentgenol 196:320–324. https://doi.org/10.2214/AJR.10.4656CrossRef Spangler ML, Zuley ML, Sumkin JH, Abrams G, Ganott MA, Hakim C, Perrin R, Chough DM, Shah R, Gur D (2011) Detection and classification of calcifications on digital breast tomosynthesis and 2D digital mammography: a comparison. Am J Roentgenol 196:320–324. https://​doi.​org/​10.​2214/​AJR.​10.​4656CrossRef
63.
go back to reference Mainiero MB, Moy L, Baron P, Didwania AD, Green ED, Heller SL et al (2017) ACR appropriateness criteria® breast cancer screening. J Am Coll Radiol 14:S383–S390CrossRefPubMed Mainiero MB, Moy L, Baron P, Didwania AD, Green ED, Heller SL et al (2017) ACR appropriateness criteria® breast cancer screening. J Am Coll Radiol 14:S383–S390CrossRefPubMed
65.
go back to reference Indian Council of Medical Research. Three year report of Population Based Cancer Registries, 2009–2011. Bangalore: National Centre for Disease Informatics and Research/National Cancer Registry Programme, 2013 Indian Council of Medical Research. Three year report of Population Based Cancer Registries, 2009–2011. Bangalore: National Centre for Disease Informatics and Research/National Cancer Registry Programme, 2013
69.
go back to reference Venturini E, Losio C, Panizza P, Rodighiero MG, Fedele I, Tacchini S, Schiani E, Ravelli S, Cristel G, Panzeri MM, de Cobelli F, del Maschio A (2013) Tailored breast cancer screening program with microdose mammography, US, and MR imaging: short-term results of a pilot study in 40–49-year-old women. Radiology 268:347–355. https://doi.org/10.1148/radiol.13122278CrossRefPubMed Venturini E, Losio C, Panizza P, Rodighiero MG, Fedele I, Tacchini S, Schiani E, Ravelli S, Cristel G, Panzeri MM, de Cobelli F, del Maschio A (2013) Tailored breast cancer screening program with microdose mammography, US, and MR imaging: short-term results of a pilot study in 40–49-year-old women. Radiology 268:347–355. https://​doi.​org/​10.​1148/​radiol.​13122278CrossRefPubMed
70.
go back to reference Tagliafico AS, Mariscotti G, Valdora F, Durando M, Nori J, la Forgia D, Rosenberg I, Caumo F, Gandolfo N, Sormani MP, Signori A, Calabrese M, Houssami N (2018) A prospective comparative trial of adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts (ASTOUND-2). Eur J Cancer 104:39–46. https://doi.org/10.1016/j.ejca.2018.08.029CrossRefPubMed Tagliafico AS, Mariscotti G, Valdora F, Durando M, Nori J, la Forgia D, Rosenberg I, Caumo F, Gandolfo N, Sormani MP, Signori A, Calabrese M, Houssami N (2018) A prospective comparative trial of adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts (ASTOUND-2). Eur J Cancer 104:39–46. https://​doi.​org/​10.​1016/​j.​ejca.​2018.​08.​029CrossRefPubMed
72.
73.
go back to reference Skaane P, Bandos AI, Eben EB, Jebsen IN, Krager M, Haakenaasen U, Ekseth U, Izadi M, Hofvind S, Gullien R (2014) Two-view digital breast tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast tomosynthesis with full-field digital mammographic images. Radiology 271:655–663. https://doi.org/10.1148/radiol.13131391CrossRefPubMed Skaane P, Bandos AI, Eben EB, Jebsen IN, Krager M, Haakenaasen U, Ekseth U, Izadi M, Hofvind S, Gullien R (2014) Two-view digital breast tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast tomosynthesis with full-field digital mammographic images. Radiology 271:655–663. https://​doi.​org/​10.​1148/​radiol.​13131391CrossRefPubMed
80.
go back to reference Amir T, Barafaldi B, Zuckerman SP, Maidment ADA, Conant EF (2018) Comparison between radiation dose of 2D digital versus digital tomosynthesis guided stereotactic breast biopsies: tomosynthesis wins! [abstr]. In: Radiological Society of North America scientific assembly and annual meeting program. Radiological Society of North America, Oak Brook Amir T, Barafaldi B, Zuckerman SP, Maidment ADA, Conant EF (2018) Comparison between radiation dose of 2D digital versus digital tomosynthesis guided stereotactic breast biopsies: tomosynthesis wins! [abstr]. In: Radiological Society of North America scientific assembly and annual meeting program. Radiological Society of North America, Oak Brook
Metadata
Title
Digital Breast Tomosynthesis: an Overview
Authors
Ekta Dhamija
Malvika Gulati
S. V. S. Deo
Ajay Gogia
Smriti Hari
Publication date
01-06-2021
Publisher
Springer India
Published in
Indian Journal of Surgical Oncology / Issue 2/2021
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI
https://doi.org/10.1007/s13193-021-01310-y

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