Introduction Breast cancer is the most common malignancy in women and the most common cause of death due to cancer in women (1). Mammography is worldwide used as the technique of choice to detect breast cancers.
Several trials have demonstrated that mammography can reduce the mortality due to breast cancer up to 30% (2),
but some authors do not agree with these results (3).
an important controversy exists regarding the results of the population-based screening campaigns (3).
Methods and materials
Patients selection From November 2011 to December 2013,
a total number of 9121 women underwent digital mammography at our institution.
According to our protocol, additional DBT and US were routinely performed for all patients showing density patterns 2,
3 and 4 according to the American College of Radiology (ACR),
as well as for all patients with lesions detected on digital mammography (using DBT and US asproblem solving techniques). An informed consent was given to all patients. Study design...
A sample of 1042 patients was selected (mean age: 51.6,
Out of them,
84 patients had histologically proven malignant lesions and 258patients had benign lesions.
The remaining 700 patients had no lesions or benign lesions with no biopsy but no changes during at least one year follow up. The distribution of the malignant cases according to the histology and the detection by the different techniques are shown in this table. DM detected 69% of malignant tumors,
while additional US...
the addition of a second diagnostic technique (DBT and/or US) significantly increased the sensitivity and the AUC´s of DM,
but decreased the specificity. Due to the well-known limitations of US,
we suggest that in a screening setting the combination DM+DBT offers a high sensitivity with an acceptable specificity. However,
in a clinical setting,
where US canbe profusely used,
the combination DM+US could be a right choice.
1.Abdulrahman GO Jr,
Epidemiology of breast cancer in Europe andAfrica.
J Cancer Epidemiol 2012:915610. 2.Tabár L,
Swedish two-county trial: impact ofmammographic screening on breast cancer mortality during 3 decades.
Radiology2011 ;260:658-663. 3.Jørgensen KJ,
Is mammographic screening justifiableconsidering its substantial overdiagnosis rate and minor effect on mortality?Radiology 2011 ;260:621-627. 4.Hooley RJ,