Learning objectives
To learn how Digital Breast Tomosynthesis (DBT) may help to overcome the difficulties of preoperative wire localization of subtle mammographic abnormalities.
Background
Standard Two Dimensional Mammography (2DM) with grid or stereotaxis is a well established method for preoperative mammographic localization of non palpable breast lesions. In some cases visualization of the lesion may be difficult during the procedure due to subtle mammographic features e.g distortion, small lesion, dense or nodular background parenchymal pattern.DBT allows clear visualization of such subtle subtle lesions because of lack of superimposition of overlying tissues and can be effectively used to check the localizing wire position. Specimen DBT may be carried out to...
Imaging findings OR Procedure details
Seven cases of difficultsubtle lesions are presented in which DBT has been used as an adjunct to standard 2DM during the localization process. DBT incranio-caudal and medio-lateral projections was used to check the position of the needle during the procedure allowing 3D localization of the wire. DBT of the specimen was performed after surgery to demonstrate the mammographic abnormality.CASE 1 Soft Tissue Density:Post wire 2D mammogram:Is the tip of the wire within the lesion?Post wire DBT:Yes it is!(G2 Invasive Ductal Carcinoma)CASE 2Distortion:Post wire 2D mammogram:Post...
Conclusion
DBT is effective in accurately demonstrating the position of the localizing wire prior to surgery in cases with subtle mammographic abnormalities. DBT can also be used to effectively demonstrate the abnormality within the specimen following surgery and helps with imaging-pathology correlation.
