Digital breast tomosynthesis for early detection of malignant breast microcalcification: A hospital-based cross-sectional study
DOI:
https://doi.org/10.3329/bsmmuj.v17i4.72500Keywords:
breast cancer, digital breast tomosynthesis, microcalcification, accuracyAbstract
Background: Breast cancer is the leading cause of cancer-related deaths in women. Early detection by screening is crucial for improved survival. Digital breast tomosynthesis (DBT) may offer better visibility than conventional screening. This study aims to assess the diagnostic accuracy of DBT in detecting malignant breast microcalcifications compared to histopathological findings.
Methods: This cross-sectional study was done at the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2022 to June 2023 and enrolled 35 women suspected of having breast cancer. Each patient underwent DBT and histopathology tests. The diagnostic accuracy of DBT in detecting malignant breast microcalcifications was assessed compared to the gold standard of histopathology.
Results: The average age of the participants was 48.6 years. Palpable breast lumps (91.4%) were the most common clinical presentation. Among them, 80% had malignant microcalcifications diagnosed by DBT, primarily with linear (40.0%) and segmental (28.6%) distribution. Histopathology identified 80% of cases as malignant, with ductal carcinoma in situ (34.3%) being the most prevalent type. DBT demonstrated high sensitivity (100%) and specificity (85.7%) in detecting malignant microcalcifications, resulting in an overall accuracy of 97.1%.
Conclusions: DBT has high diagnostic accuracy for detecting malignant breast microcalcifications and can be considered a valid tool for the early detection of breast microcalcifications, particularly in the context of diagnosing breast cancer.
Downloads
123
71 Review report
19
References
Sedeta ET, Jobre B, Avezbakiyev B. Breast cancer: Global patterns of incidence, mortality, and trends. J Clin Oncol. 2023;41(16_suppl):10528–10528. DOI: https://doi.org/10.1200/JCO.2023.41.16_suppl.10528
World Health Organization, 2020. WHO supports early detection and control of cervical and breast cancer in Bangladesh, Detail, News, World Health Organization. URL: https://www.who.int/bangladesh/news/detail/10-11-2020-who-supports-early- detection-and-control-of-cervical-and-breast-cancer-in-bangladesh
Amin MN, Uddin MG, Uddin MN, Rahaman MZ, Siddiqui SA, Hossain MS, Islam MR, Hasan MN, Uddin SMN. A hospital based survey to evaluate knowledge, awareness and perceived barriers regarding breast cancer screening among females in Bangladesh. Heliyon. 2020 Apr 10;6(4):e03753. DOI: https://doi.org/10.1016/j.heliyon.2020.e03753
Begum SA, Mahmud T, Rahman T, Zannat J, Khatun F, Nahar K, Towhida M, Joarder M, Harun A, Sharmin F. Knowledge, Attitude and Practice of Bangladeshi Women towards Breast Cancer: A Cross Sectional Study. Mymensingh Med J. 2019 Jan;28(1):96-104. DOI: https://pubmed.ncbi.nlm.nih.gov/30755557/
Shamsi T. Burden of breast cancer in Bangladesh-current and future and financing treatment with link to willingness to pay. Int J Community Med Public Heal. 2021;8(11):5525. DOI: https://doi.org/10.18203/2394-6040.ijcmph20214295
Sauter ER, Ross E, Daly M, Klein-Szanto A, Engstrom PF, Sorling A, Malick J, Ehya H. Nipple aspirate fluid: A promising non-invasive method to identify cellular markers of breast cancer risk. Br J Cancer. 1997;76(4):494–501. DOI: https://doi.org/10.1038/bjc.1997.415
Poplack SP, Tosteson TD, Kogel CA, Nagy HM. Digital breast tomosynthesis: Initial experience in 98 women with abnormal digital screening mammography. Am J Roentgenol. 2007;189(3):616–623. DOI: https://doi.org/10.2214/AJR.07.2231
Gartner Roth R, Maidment ADA, Weinstein SP, Orel Roth S, Conant EF. Digital breast tomosynthesis: Lessons learned from early clinical implementation. Radiographics. 2014;34(4). DOI: https://doi.org/10.1148/rg.344130087
Ratanaprasatporn L, Chikarmane SA, Giess CS. Strengths and weaknesses of synthetic mammography in screening. Radiographics. 2017;37(7):1913–1927. DOI: https://doi.org/10.1148/rg.2017170032
Peppard HR, Nicholson BE, Rochman CM, Merchant JK, Mayo RC, Harvey JA. Digital breast tomosynthesis in the diagnostic setting: Indications and clinical applications. Radiographics. 2015;35(4):975–990. DOI: https://doi.org/10.1148/rg.2015140204
Mariscotti G, Durando M, Houssami N, Fasciano M, Tagliafico A, Bosco D, Casella C, Bogetti C, Bergamasco L, Fonio P, Gandini G. Comparison of synthetic mammography, reconstructed from digital breast tomosynthesis, and digital mammography: evaluation of lesion conspicuity and BI-RADS assessment categories. Breast Cancer Res Treat. 2017;166(3):765–73. DOI: https://doi.org/10.1007/s10549-017-4458-4453
Korhonen KE, Weinstein SP, McDonald ES, Conant EF. Strategies to increase cancer detection: Review of true-positive and false-negative results at digital breast tomosynthesis screening. Radiographics. 2016;36(7):1954–1965. DOI: https://doi.org/10.1148/rg.2016160049
Teertstra HJ, Loo CE, Van Den Bosch MAAJ, Van Tinteren H, Rutgers EJT, Muller SH, Gilhuijs KG. Breast tomosynthesis in clinical practice: Initial results. Eur Radiol. 2010;20(1):16–24. DOI: https://doi.org/10.1007/s00330-009-1523-2
Tagliafico A, Astengo D, Cavagnetto F, Rosasco R, Rescinito G, Monetti F, Calabrese M. One-to-one comparison between digital spot compression view and digital breast tomosynthesis. Eur Radiol. 2012;22(3):539–544. DOI: https://doi.org/10.1007/s00330-011-2305-1
Skaane P, Bandos AI, Gullien R, Eben EB, Ekseth U, Haakenaasen U, Izadi M, Jebsen IN, Jahr G, Krager M, Niklason LT, Hofvind S, Gur D. Comparison of digital mammography alone and digital mammography plus tomosynthesis in a populationbased screening program. Radiology. 2013;267(1):47–56. DOI: https://doi.org/10.1148/radiol.12121373
Byun J, Lee JE, Cha ES, Chung J, Kim JH. Visualization of breast microcalcifications on digital breast tomosynthesis and 2-dimensional digital mammography using specimens. Breast Cancer Basic Clin Res. 2017;11:1–7. DOI: https://doi.org/10.1177/1178223417703388
Destounis S, Arieno A, Morgan R. Preliminary clinical experience with digital breast tomosynthesis in the visualization of breast microcalcifications. J Clin Imaging Sci. 2013;3(1):1–5. DOI: https://doi.org/10.4103/2156-7514.124099
Basha MAA, Safwat HK, Alaa Eldin AM, Dawoud HA, Hassanin AM. The added value of digital breast tomosynthesis in improving diagnostic performance of BI-RADS categorization of mammographically indeterminate breast lesions. Insights Imaging. 2020;11(1). DOI: https://doi.org/10.1186/s13244-020-0835-2
Spak DA, Plaxco JS, Santiago L, Dryden MJ, Dogan BE. BI-RADS® fifth edition: A summary of changes. Diagn Interv Imaging. 2017;98(3):179–190. DOI: http://dx.doi.org/10.1016/j.diii.2017.01.001
Roganovic D, Djilas D, Vujnovic S, Pavic D, Stojanov D. Breast MRI, digital mammography and breast tomosynthesis: Comparison of three methods for early detection of breast cancer. Bosn J Basic Med Sci. 2015;15(4):64–68. DOI: https://doi.org/10.17305/bjbms.2015.616
Chowdhury FA, Islam MF, Arefin MK, Akter H, Tithy SA, Sabrin F, Mahmud F, Khan AS, Alam MT. Demographic Characteristics of Patients with Breast Cancer in Bangladesh: A Single-Centre Study. Mymensingh Med J. 2023 Jul;32(3):764-768. PMID: 37391971. DOI: https://pubmed.ncbi.nlm.nih.gov/37391971/
Koo MM, von Wagner C, Abel GA, McPhail S, Rubin GP, Lyratzopoulos G. Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. Cancer Epidemiol. 2017;48:140–6. DOI: http://dx.doi.org/10.1016/j.canep.2017.04.010
Kuwabara N, Takuwa H, Takeuchi M, Kawashima H. Can digital breast tomosynthesis improve identification of malignant calcifications? Radiol Phys Technol. 2020;13(3):249–55. DOI: https://doi.org/10.1007/s12194-020-00576-1
Rao AA, Feneis J, Lalonde C, Ojeda-Fournier H. A Pictorial Review of Changes in the BI-RADS Fifth Edition. Radiographics. 2016 May-Jun;36(3):623-39. DOI: https://doi.org/10.1148/rg.2016150178
Arancibia Hernández PL, Taub Estrada T, López Pizarro A, Díaz Cisternas ML, Sáez Tapia C. Breast calcifications: Description and classification according to BI-RADS 5th edition. Rev Chil Radiol. 2016;22(2):80–91. DOI: http://dx.doi.org/10.1016/j.rchira.2016.06.004
Salvatorelli L, Puzzo L, Vecchio GM, Caltabiano R, Virz V, Magro G. Ductal Carcinoma In Situ of the Breast: An Update with Emphasis on Radiological and Morphological Features as Predictive Prognostic Factors. 2020;1–11. DOI: https://doi.org/10.3390/cancers12030609
Apesteguía L, Pina LJ. Ultrasound-guided core-needle biopsy of breast lesions. Insights Imaging. 2011;2(4):493–500. DOI: https://doi.org/10.1007/s13244-011-0090-7
Shin K, Teichgraeber D, Martaindale S, Whitman GJ. Tomosynthesis-guided core biopsy of the breast: Why and how to use it. J Clin Imaging Sci. 2018;8(1):1–5. DOI: https://doi.org/10.4103/jcis.JCIS_10_18
Sharmin T, Nikhat N, Rayna SE, Khalequzzaman M, Khan FA, Rahman KT, Islam T, Haque SE, Ahsan H, Kamal M, Islaml SS. Types and distribution of cancer patients attending in a tertiary care hospital of Bangladesh. Bangabandhu Sheikh Mujib Med Univ J. 2022;15(1):43–49. DOI: https://doi.org/10.3329/bsmmuj.v15i1.58427
Liu W, Long M, Peng L, Qu C, Guo R, Kang Z, Wang J, Wu J, Wang X. Digital breast tomosynthesis improves diagnostic accuracy of breast microcalcifications. Int J Imaging Syst Technol. 2021;31(2):555–61. https://doi.org/10.1002/ima.22481
Seo N, Kim HH, Shin HJ, Cha JH, Kim H, Moon JH, Gong G, Ahn SH, Son BH. Digital breast tomosynthesis versus full-field digital mammography: Comparison of the accuracy of lesion measurement and characterization using specimens. Acta radiol. 2014;55(6):661–667. DOI: https://doi.org/10.1177/0284185113503636
Li J, Zhang H, Jiang H, Guo X, Zhang Y, Qi D, Guan J, Liu Z, Wu E, Luo S. Diagnostic Performance of Digital Breast Tomosynthesis for Breast Suspicious Calcifications From Various Populations: A Comparison With Full-field Digital Mammography. Comput Struct Biotechnol J. 2019;17:82–89. DOI: https://doi.org/10.1016/j.csbj.2018.12.004
Ko MJ, Park DA, Kim SH, Ko ES, Shin KH, Lim W, Kwak BS, Chang JM. Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis. Korean J Radiol. 2021 Aug;22(8):1240-1252. DOI: https://doi.org/10.3348/kjr.2020.1227
Bernardi D, Gentilini MA, De Nisi M, Pellegrini M, Fantò C, Valentini M, Sabatino V, Luparia A, Houssami N. Effect of implementing digital breast tomosynthesis (DBT) instead of mammography on population screening outcomes including interval cancer rates: Results of the Trento DBT pilot evaluation. Breast. 2020 Apr;50:135-140. DOI: https://doi.org/10.1016/j.breast.2019.09.012
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Mst. Syeeda Showkat, Bishwajit Bhowmik, Syeda Naheed Sultana, Mahbuba Shirin, Shohaila Sharmin, Ashis Kumar Sarkar, Parisa Chowdhury
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
