A comparative efficacy study of diagnostic digital breast tomosynthesis and digital mammography in BI-RADS 4 breast cancer diagnosis.

Autor: Ezeana CF; Dept. of Systems Medicine and Bioengineering, Houston Methodist Cancer Center, Houston Methodist Hospital, Houston, TX, USA. Electronic address: cfezeana@houstonmethodist.org., Puppala M; Dept. of Systems Medicine and Bioengineering, Houston Methodist Cancer Center, Houston Methodist Hospital, Houston, TX, USA. Electronic address: mpuppala@houstonmethodist.org., Wang L; Dept. of Systems Medicine and Bioengineering, Houston Methodist Cancer Center, Houston Methodist Hospital, Houston, TX, USA. Electronic address: lwang3@houstonmethodist.org., Chang JC; Houston Methodist Cancer Center, Houston Methodist Hospital, Houston, TX, USA. Electronic address: jcchang@houstonmethodist.org., Wong STC; Dept. of Systems Medicine and Bioengineering, Houston Methodist Cancer Center, Houston Methodist Hospital, Houston, TX, USA; Department of Radiology, Houston Methodist Hospital, Houston, TX, USA. Electronic address: stwong@houstonmethodist.org.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2022 Aug; Vol. 153, pp. 110361. Date of Electronic Publication: 2022 May 17.
DOI: 10.1016/j.ejrad.2022.110361
Abstrakt: Purpose: Probability of malignancy for BI-RADS 4-designated breast lesions ranges from 2% to 95%, contributing to high false-positive biopsy rates. We compare clinical performance of digital breast tomosynthesis (DBT) versus digital mammography (2D) among our BI-RADS 4 population without prior history of breast cancer.
Methods: We extracted retrospective data i.e., clinical, mammogram reports, and biopsy data, from electronic medical records across Houston Methodist's nine hospitals for patients who underwent diagnostic examinations using both modalities (02/01/2015 - 09/30/2020). 2D and DBT cohorts were not intra-individual matched, and there was no direct mammogram evaluation. Using Student's t test, Fisher's exact test, and Chi-squared test, we evaluated the data to determine statistical significance of differences between modalities in BI-RADS 4 cases. We calculated adjusted odds-ratio between modalities for cancer detection rate (CDR) and biopsy-derived positive predictive value (PPV3).
Results: There were 6,356 encounters (6,020 patients) in 2D and 5,896 encounters (5,637 patients) in DBT assessed as BI-RADS 4. Using Fisher's exact test, DBT mammography cases were significantly assessed as BI-RADS 4 5.66% more often than those undergoing 2D mammography, P = 0.0046 (1.0566 95% CI: 1.0169-1.0977). The CDRs were 112.65 (2D) and 120.76 (DBT), adjusted odds-ratio: 1.04 (0.93, 1.16)), P = 0.5029, while PPV3 were 14.41% (2D) and 15.99% (DBT), adjusted odds-ratio: 1.09 (0.97, 1.22), P = 0.1483; both logistic regression-adjusted for all other factors.
Conclusion: DBT did not achieve better performance and sensitivity in assigning BI-RADS 4 cases compared with 2D, showed no significant advantage in CDR and PPV3, and does not reduce false-positive biopsies among BI-RADS 4-assessed patients.
(Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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