الفهرس 
ANATOMY OF THE BREASTOnly 14 pages are availabe for public view
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Abstract
B
reast cancer affects 2.1 million women annually and accounts for the majority of female cancer-related fatalities.
It is the most common malignancy among women. In Egypt, it is also the most prevalent cancer among women. In women, it is the cause of 32% of cancer cases.
The main breast imaging technique for early breast cancer diagnosis and detection is digital mammography (DM). Still, there are certain restrictions. DM’s application in cases of dense breast tissue is one of its main disadvantages. Due to decreased contrast between a potential tumor and surrounding breast tissue, as well as the potential for tissue summation to obscure lesions, DM has low sensitivity and specificity in women with radiographically dense breasts.
The use of digital breast tomosynthesis (DBT) for breast imaging is becoming increasingly common due to improvements in screening and diagnostic imaging results. Lesion detection, characterization, and localization are improved due to the reduced confounding effect of overlapping tissue due to the additional information obtained from the tomosynthesis acquisition. Furthermore, compared to imaging with two-dimensional full-field digital mammography alone, a more efficient imaging work-up is possible owing to the quasi three-dimensional information derived from the reconstructed DBT data set.
The aim of our study was to assess the sensitivity and specificity of FFDM and DBT in the detection of breast cancer (BC) in women who had different breast densities. Its correlation with ultrasound and histology confirms tomosynthesis’s superior role.
In this cross-sectional (prospective) study, which involved 100 females with positive breast findings from either digital mammography or digital breast tomosynthesis, the Radiology Departments of Ain Shams University hospitals and Mataria Teaching Hospital participated. The initial imaging modality used was FFDM, which was then followed by DBT, ultrasound (US) to establish a correlation with mammographic results, and histopathology to confirm the cancer diagnosis.
Our results showed that:
Regarding the accuracy between Mammography & Tomo and pathology as a gold standard method for mass detection within the non-dense group:
The results according to mammography are classified into: sensitivity and specificity of 82.5 % and 80 % respectively. The accuracy of mammography is 82%.
For tomosynthesis, they are classified into: sensitivity and specificity of 100 and 90 % respectively. The accuracy of tomosynthesis is 98 %.
Regarding the accuracy between Mammography & Tomo and pathology as a gold standard method for mass detection within the dense group:
The results according to mammography are classified into: sensitivity and specificity of 60 % and 76 % respectively. The accuracy of mammography is 68%.
For tomosynthesis, they are classified into sensitivity and specificity of 100 and 92 % respectively. The accuracy of tomosynthesis is 96 %.
In our study we found that DBT exceeded Mammography in terms of sensitivity, specificity, and diagnostic accuracy at all breast densities, particularly dense breasts. This is because DBT enables more accurate identification and characterization of breast lesions, which reduces the number of recalled cases and negative biopsies.
Patients receiving DBT are subjected to increased radiation exposure, which raises health concerns, additionally, postprocessing procedures need more time and costs so we recommend DBT for women who exhibit symptoms and for the investigation of any suspicious findings shown on screening mammography.
CONCLUSION
D
igital breast tomosynthesis has shown to be an effective 3D imaging method for breast imaging, serving as a diagnostic and screening instrument. Compared to digital mammography, it is more accurate in detecting breast lesions and can produce images of higher diagnostic quality, particularly in dense breast tissue, which poses the biggest challenge to breast imaging. In terms of displaying tissue overlap, tumor characteristics, lesion margins, extent, and the multifocality and multicentricity of malignant lesions, it is more sensitive and specific than digital mammography. We conclude that DBT surpassed Mammography in terms of sensitivity, specificity, and diagnostic accuracy at all breast densities, particularly dense breasts. This is because DBT enables more accurate identification and characterization of breast lesions, which reduces the number of recalled cases and negative biopsies.