A sample of 1042 patients was selected (mean age: 51.6,
range: 22-88).
Out of them,
84 patients had histologically proven malignant lesions and 258 patients 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.
Fig. 1
The distribution of the malignant cases according to the histology and the detection by the different techniques are shown in this table.
Fig. 2
DM detected 69% of malignant tumors,
while additional US increased the sensitivity by 23.8%,
additional DBT by 17.8% and the combination DBT+US detected 29.76% additional tumors.
The sensitivity and specificity of DM and the different combinations of the three techniques are shown in this slice.
Fig. 3
The highest sensitivity was achieved by the combination of the three techniques (DM+US+DBT),
reaching 98.81%.
The sensitivity of DM+DBT as well as the sensitivity of DM+US were significantly higher (p<0.05) than the sensitivity of DM.
Fig. 4
There were not statistical differences between DM+US and DM+DBT regarding the sensitivity.
Fig. 5
Conversely,
the specificity of DM+DBT and DM+US were significantly lower than the specificity of DM (p<0.05).
The specificity of the combination DM+DBT was significantly higher than the one with DM+US (p<0.05).
Fig. 6
Fig. 7
The ROC curves and the comparison among the different techniques are shown in this figure.
Fig. 8
The addition of US and/or DBT to DM significantly increased the AUC.
In the comparison between DM+US vs DM+DBT there were no significant results (p=0.73).
Cases
Fig. 9: 53 year-old asympthomatic woman. This is an example of an additional breast tumor detected by US: both mammogram and DBT were normal
Fig. 10: 58 year-old asympthomatic woman. This is an example of another tumor detected by additional DBT, the remaining techniques were negative.