A comparison of full-field digital mammography (FFDM) with digital breast tomosynthesis (DBT) in the detection of microcalcifications by correlating mammographic and pathologic findings

Abstract

Introduction: Breast micro-calcifications primarily represent benign conditions; they might be regarded as the earliest presentations of malignancies. As a well-known procedure, full-field digital mammography (FFDM) is a 2-dimensional (2-D) imaging modality most frequently used in breast cancer screening. DBT, i.e., digital breast tomosynthesis, on the other hand, is a 3- 3-dimensional (3-D) modality increasingly attracting the attention of researchers in the field for clinical applications. Objectives: The present study compares FFDM values against DBT technique data- considered a valuable means of screening breast cancers. Patients and Methods: This is a cross-sectional study conducted on 92 suspected breast cancer patients who underwent screening assessments using both FFDM and DBT. The breast calcification and density categories were identified according to ACR BI-RADS (American College of Radiology Breast Imaging- Reporting and Data System). The calcifications were categorized as benign (BIRADS 2 and 3) or malignant (BIRADS 4 and 5). The histopathological findings from the biopsied lesions were considered the gold standard for breast cancer diagnosis. The outcomes of FFDM and DBT were compared. Results: The total sensitivity of DBT in identifying benign versus malignant lesions was 96.7. In the case of FFMD, the sensitivity value was 90.2. On the other hand, both modalities revealed similar specificity, accounting for 8.7. The area under the curve (AUC) accounted for 0.527 for DBT and 0.505 for FFDM. The overall agreement coefficient for the two radiologists in the identification of micro-calcifications accounted for 0.613 (95 CI: 0.394-0.823). This agreement coefficient for FFDM was 0.676 (95 CI: 0.412, 0.940), and the value for the DBT procedure was 0.517 (95 CI: 0.147, 0.887). Conclusion: According to the current study, DBT can be considered a powerful tool in screening and diagnosing microcalcifications such as FFDM in breast tissue. Although the sensitivity of DBT is remarkably high, its specificity is not justifiable.