Digital breast tomosynthesis can detect malignancies in developing asymmetries at a higher rate than digital mammography and proved to be superior in doing so without correlating ultrasound results, according to research published this week in Radiology.
Breast imaging has benefited from the evolution of DBT. The technology’s sensitivity to abnormalities and changes is particularly advantageous when monitoring developing asymmetries, as it can distinguish abnormalities from overlapping breast tissue routinely seen on images. Developing asymmetries are rare, but they do come with an increased risk of malignancy. Therefore research is imperative to improve detection rates.
“Developing asymmetries without sonographic correlate remain a challenge,” corresponding author Emily B. Ambinder, MD, with the Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins School of Medicine, and co-authors wrote.
For this study, researchers focused on the outcomes and predictors of malignancy in developing asymmetries detected on DBT without sonographic correlate. Done retrospectively, it included 83 women who underwent breast tomosynthesis-guided biopsies.
Most pathologic findings revealed the asymmetries as benign (68 of 85), with lesions commonly representing fibrocystic change, stromal fibrosis and fat necrosis. Malignancies were detected in 20% (17 of 85) of patients. Of those 17 patients, 15 were found to have invasive cancer, particularly among women who had a history of breast cancer.
The 20% malignancy rate noted in the research is higher than rates of detection previous studies have analyzed in digital mammography.
The authors note these results further confirm the notion that all developing asymmetries without sonographic correlate be treated as suspicious enough to biopsy, especially in older patients and patients with a history of breast cancer.
“Given the high rate of malignancy associated with developing asymmetries regardless of the presence of sonographic correlates, these studies reaffirm our finding that developing asymmetries should be biopsied even without sonographic correlates,” the doctors continued.
You can read the detailed study in Radiology.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.