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Digital Breast Tomosynthesis: Overcoming Limitations of Conventional Mammography

Bob Kirsh

*Medical Writer, MedEd andsoforth, Ltd; Past President of the Metro New York chapter of the American Medical Writers Association; Box 3, Maryknoll, NY 10545. Phone: 914-762-0908.

Disclosures: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

While mammography is the only population-level modality shown in randomized trials to reduce breast cancer mortality, current approaches remain less than perfect. Because full-field digital mammography (FFDM) superimposes breast tissue or parenchymal density, cancers may be obscured and normal structures may be difficult to discriminate as being noncancerous. Digital breast tomosynthesis (DBT), a relatively new modality, has the potential to overcome some of the limitations of conventional mammography.

Some research has shown that DBT may be superior to FFDM in: identifying both small invasive and lobular cancers, leading to fewer false-positive findings, less overdiagnosis, and a lower rate of biopsy; delineating tumor borders (lesion margins); detecting the architectural distortion of lesions; and clearer delineation of legion morphology. Requiring less breast compression than FFMD, DBT has the potential to be more comfortable for patients as well.

Digital breast imaging has also shown promise in patients who: have been recalled following initial screening; for patients requiring surgical planning; and for patients with dense breasts. Overall, DBT is considered to be an emerging and promising technology achieving improved diagnostic accuracy and a reduced patient recall rate, resulting in less patient anxiety and stress, and possibly, a higher likelihood of reattending routine screening. Continued examination of the effectiveness and accuracy of DBT versus FFMD is still underway, however, the evidence thus far suggests that DBT may become a preferred modality in breast imaging.

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