The role of digital breast tomosynthesis in the breast assessment clinic: a review

• Published in: Journal of medical radiation sciences 2017-09, Vol.64 (3), p.203-211
• Main Authors: Mall, Suneeta, Lewis, Sarah, Brennan, Patrick, Noakes, Jennie, Mello‐Thoms, Claudia
• Format: Article
• Language: English
• Subjects: Assessment; biopsy; Breast - diagnostic imaging; Breast cancer; Breast Neoplasms - diagnostic imaging; Cancer; Computed tomography; DBT; diagnosis; digital breast tomosynthesis; Humans; Literature reviews; Localization; Magnetic resonance imaging; Mammography; Mammography - methods; Medical diagnosis; Medical screening; NMR; Nuclear magnetic resonance; Review; Sensitivity and Specificity; Studies; Visibility
• ISSN: 2051-3895; 2051-3909
• DOI: 10.1002/jmrs.230

Mammography has long been considered as the primary technique in breast cancer detection and assessment. Despite low specificity, mammography has been preferred over other contemporary techniques such as magnetic resonance imaging (MRI), computed tomography (CT) and ultrasonography (US) due to superior sensitivity and significant health economic benefits. The development of a new technique, a limited angle cone beam pseudo‐three‐dimensional tomosynthesis, digital breast tomosynthesis (DBT), has gained momentum. Several preliminary studies and ongoing trials are showing evidence of the benefits of DBT in improving lesion visibility, accuracy of cancer detection and observer performance. This raises the possibility of adoption of DBT in the breast cancer assessment clinic, wherein confirming or dismissing the presence of malignancy (at the potential site identified during screening) is of utmost importance. Identification of suspected malignancy in terms of lesion characteristics and location is also essential in assessment. In this literature review, we evaluate the role of DBT for use in breast cancer assessment and its future in biopsy. Mammography has long been considered as the primary technique in breast cancer detection and assessment. Despite low specificity, mammography has been preferred over other contemporary techniques such as magnetic resonance imaging (MRI), computed tomography (CT) and ultrasonography (US) due to superior sensitivity and significant health economic benefits in a screening setting. In the last decade, the development of a new technique, a limited angle cone beam pseudo‐three‐dimensional tomosynthesis, known as digital breast tomosynthesis (DBT), has gained momentum. The pseudo‐three‐dimensional nature of DBT is currently being investigated for advances in lesion visibility, sensitivity, specificity, recall rates and observer performance. Several preliminary studies and ongoing trials are showing evidence of the benefits of DBT over mammography for screening. This raises the possibility of adoption of DBT in breast cancer assessment. In this article we focus on the role of DBT for use in breast cancer assessment (also known as diagnostic workup) and its future as a biopsy imaging modality.