Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Digital Breast Tomosynthesis Plus Ultrasound Versus Digital Mammography Plus Ultrasound for Screening Breast Cancer in Women With Dense Breasts

  • Su Min Ha (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Ann Yi (Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center) ;
  • Dahae Yim (Medical Research Collaborating Center, Seoul National University Hospital) ;
  • Myoung-jin Jang (Medical Research Collaborating Center, Seoul National University Hospital) ;
  • Bo Ra Kwon (Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center) ;
  • Sung Ui Shin (Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center) ;
  • Eun Jae Lee (Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center) ;
  • Soo Hyun Lee (Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center) ;
  • Woo Kyung Moon (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jung Min Chang (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2022.09.01
  • Accepted : 2023.02.04
  • Published : 2023.04.01
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Abstract

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.

Keywords

Acknowledgement

This study was supported by JW Medical Corporation's research grant, Seoul National University Hospital (grant no. 06-2020-2460).

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