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Keywords:
Breast, Ultrasound, Mammography, Diagnostic procedure, Cancer
Authors:
A. Elizalde, P. Garcia Barquin, M. Millor Muruzábal, J. Etxano, P. MARTÍNEZ MIRAVETE, L. J. Pina Insausti, M. Páramo; Pamplona/ES
DOI:
10.1594/ecr2015/B-0926
Purpose
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).
In fact,
an important controversy exists regarding the results of the population-based screening campaigns (3).
Probably one of the most important factors influencing the results is the breast density.
It is well known that the sensitivity of mammography drops in dense breasts (as low as 30%-48%) (4).
The main reasons are the overlapping tissue and the low contrast of tumors in comparison with the surrounding parenchyma.
Both produce false positive (recall rate) and false negative results.
This low sensitivity has induced the use of additional techniques,
such as ultrasound (US) and/or Digital Breast Tomosynthesis (DBT).
The former has been proven to have good results in dense breasts (6) but it is an operator dependent and time consuming technique.
Due to these reasons,
US is not routinely used for screening purpose,
although it plays an important role as a problem solving technique.
DBT has been the latest development of digital mammography,
acquiring multiple low-dose images of the breast and reconstructing the images in a series of multiple slices,
all of them parallel to the detector (7).
DBT has been found to increase the detection of breast cancers up to 27% (8).
Purpose
Our purpose was to evaluate the diagnostic accuracy of Digital Mammography (DM) and the combinations of DM with US and the combination of DM with DBT.