Type:
Educational Exhibit
Keywords:
Breast, Mammography, Digital radiography, Screening, Cancer
Authors:
S. Rajadurai, N. Kutaiba, S. Bigwood, K. Mehta, J. Cawson; VIC/AU
DOI:
10.1594/ranzcr2018/R-0074
Background
Standard 2D mammography remains the current standard of care for breast cancer screening.
Fig. 1: Standard MLO and CC views of the left breast obtained using digital mammography demonstrate a spiculated breast cancer.
References: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org. From the case rID: 12608
Together with ultrasound,
standard mammography is invaluable in the assessment of symptomatic women aged 35 years or older1.
However standard mammography is not without its limitations,
chief among these being the superimposition of breast tissue.
Digital breast tomosynthesis (DBT or 3D mammography) is a technique which attempts to address some of the inherent limitations in standard 2D mammography by using multiple,
rapidly acquired mammograms to construct a 3-dimensional image of the breast.
Fig. 2: Multiple tomosynthesis images can be reconstructed into a stack of images much like conventional CT.
References: Breastscreen Victoria
Recent DBT studies have demonstrated improved detection rates in the assessment of mass lesions,
architectural distortion2,
increased diagnostic certainty in the assessment of lesions3,
and while its role in screening has not yet been completely validated,
early results are promising4. Assessment of focal and spiculated mass lesions appears much improved,
even with lesions as small as 7mm5.
DBT has also been shown to have utility in the assessment of architectural distortion (AD) with improved visibility in resolving “apparent” or “pseudo-” AD.