Potential Role of a Tomosynthesis low dose protocol in the screening setting in women with breast implants

Congress:

EuroSafe 2023

Poster Number:

ESI-21394

Type:

EuroSafe Imaging

Keywords:

Breast, Mammography, Technical aspects, Cancer

Authors:

R. FEDELE, E. Pofi, R. Stella, D. D'Ottavio, P. Ragucci, S. Pedilarco, I. Valenti

DOI:

DOI-Link:

https://dx.doi.org/

Purpose or learning objective

We investigated the use of a tomosynthesis low dose protocol for the study of women with breast implants in the breast screening setting.

Methods or background

Guidelines in both Italy , UK and US agree that 2D mammography, in the presence of breast implant, does not offer a reliable diagnosis and therefore invite clinicians to perform the Eklund maneuver. Due to the typical radiopacity of implants, Tomosynthesis is not currently the technique of choice for screening this type of breast. In this study, we wanted to experiment a protocol in which Tomosynthesis can be used to provide more diagnostic information even in the presence of breast implants, reconciling the technical, methodological...

Results or findings

In our patients cohort we demonstrated that, the study in Mammography mode, with only four projections with prosthesis included, with standard exposure meter, is associated with an average glandular dose of 7.5 mGy. If the Eklund maneuver is also performed in Tomosynthesis mode, the woman is exposed to an average of 11 mGy in total. A low-dose configuration of the AEC, is associated instead with an average glandular dose equal to 9.2 mGy total. This configuration allowed a maximum amount of radiographic information currently possible,...

Conclusion

Our analysis highlights that the use of a low dose tomosynthesis protocol in the screening setting allow a reduction in radiation dose exposure maintaining adequate image quality and maximizing the diagnostic performance in women with breast implant.

References

1. Miglioretti DL, Rutter CM, Geller BM, et al. Effect of Breast Augmentation on the Accuracy of Mammography and Cancer Characteristics. JAMA.2004;291(4):442–450. doi:10.1001/jama.291.4.442 2. LavigneE,HolowatyE J,PanS Y,VilleneuveP J,JohnsonK C,FergussonD Aet al.Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studiesBMJ2013;346:f2399doi:10.1136/bmj.f2399 3. Ekpo EU, Alakhras M, Brennan P. Errors in Mammography Cannot be Solved Through Technology Alone. Asian Pac J Cancer Prev. 2018 Feb 26;19(2):291-301. doi: 10.22034/APJCP.2018.19.2.291. 4.Majid AS, de Paredes ES, Doherty RD, Sharma NR, Salvador X....

Personal information and conflict of interest

R. FEDELE: Speaker: Breast Technician Board Member: Project Manager Author: Radiology Technician E. Pofi: Advisory Board: breast doctor Author: Radiologist R. Stella: Board Member: Consultant Author: Breast Doctor D. D'Ottavio: Investigator: Breast Technician Board Member: Radiology Technician P. Ragucci: Consultant: Technical Adviser Board Member: Radiology Technician S. Pedilarco: Consultant: Technical Adviser Advisory Board: Radiology Technician I. Valenti: Investigator: Consultant Investigator: Radiology Technician

Fig 1: Average glandular dose with Standard dose algorithm

Fig 2: Average glandular dose with exposure control algorithm

Fig 3: Average glandular dose for Eklund projections and with complete breast implant

Fig 4: MLO FFDM with breast implants with exposure control algorithm

Fig 5: CC FFDM with breast implants with exposure control algorithm

Fig 6: Standard Algorithm vs Low Dose Algorithm in tomosynthesis