DBT outperforms FFDM when screening patients with dense breast tissue

Invasive lobular, low-grade and HER-2-negative breast cancers are more detectable with digital breast tomosynthesis (DBT) than conventional full-field digital mammography (FFDM) when imaging patients with dense breasts, according to a new study published in the Korean Journal of Radiology.

The authors asked three blinded radiologists to review DBT and FFDM images from 288 patients with dense breasts with a mean age of 48.5 years. They reviewed the images during two separate review sessions held at least one month apart, making notes where they detected tumors. Two non-blinded radiologists then reviewed DBT and FFDM images as well as ultrasound and MR images. The non-blinded radiologists scored the work of each individual blinded radiologist to determine a “detectability score” for all of the malignancies.

Overall, more than 13 percent of breast cancers were only detectable with DBT. While more than 63 percent were detectable with both DBT and FFDM, 23 percent were not detected with either modality. DBT detected more lobular-type cancers, more low-grade cancers and more HER-2-negative cancers. The most common results when cancers were surrounded by mostly glandular tissue was that they were missed by both DBT and FFDM.

“Our findings indicated that DBT images were superior to conventional FFDM images with regard to breast cancer detectability in dense breasts, suggesting that DBT may be more effective in screening for breast cancer in patients with dense breasts,” wrote author Soo Hyun Lee, MD, department of radiology at Chungbuk National University Hospital in Cheongju, Korea, and colleagues. The authors noted that DBT “is still limited by the presence of surrounding glandular tissue in dense breasts.”