Tomosynthesis Analysis: Advantages, Disadvantages, Comparison with Mammograms
Digital Breast Tomosynthesis (DBT), also known as 3D mammography, and standard mammography (2D mammography) are two primary methods used for breast cancer screening. While both techniques have their merits, they differ significantly in terms of imaging technique, effectiveness, benefits, and risks.
### Imaging Technique
Standard mammography produces a flat, two-dimensional image of the breast, which can sometimes cause overlapping tissues to obscure abnormalities or create false impressions. In contrast, DBT acquires multiple X-ray images from different angles around the breast and reconstructs them into thin layered slices, resulting in a three-dimensional representation. This allows radiologists to examine breast tissue layer by layer, reducing the effect of overlapping structures.
### Effectiveness
DBT has shown improved cancer detection rates, with a meta-analysis of multiple studies indicating a 29% higher detection rate for invasive breast cancers compared to 2D mammography alone. Additionally, DBT has demonstrated better diagnostic accuracy, with higher area under the ROC curve (AUC) values, especially in screening settings. It outperforms 2D mammography in both screening and clinical settings, though the gains may depend on reader experience.
### Benefits
The 3D images provided by DBT reduce tissue overlap and artifacts, making it easier to detect small tumors and abnormalities. Furthermore, DBT lowers the number of unnecessary callbacks and biopsies by reducing superimposed structures that can mimic cancer. DBT is particularly beneficial for women with dense breast tissue, where standard mammograms may be less sensitive.
### Risks and Considerations
DBT typically involves a slightly higher radiation dose due to multiple image acquisitions, but this dose remains within safe limits and is comparable to or less than the dose in combined 2D and DBT exams. However, the diagnostic improvement with DBT can depend on the experience of the interpreting radiologist.
### Cost and Access
DBT equipment may be more expensive and less widely available than standard mammography. This lack of insurance coverage may contribute to disparities in health outcomes among people with different levels of income.
### Summary
In conclusion, DBT provides a more detailed, three-dimensional view of breast tissue, enhancing cancer detection and reducing false positives, especially beneficial in women with dense breasts. However, it involves a slightly higher radiation dose and cost, with diagnostic gains partly influenced by radiologist experience.
Women's health resources are available for more research-backed information and in-depth resources on women's health. Annual screening for women aged 45 to 54, and annual screening or every other year for women aged 55 and older is recommended by the American Cancer Society. Finding a nearby facility that offers DBT may be difficult, and insurance coverage for DBT will vary by insurance provider and location.
Early detection and treatment of breast cancer are the most important ways to improve a person's outlook. The cost of DBT depends on location and insurance coverage, with one 2021 study estimating costs around $208. An MRI scan can help a doctor diagnose and assess a mass after surgery or radiation therapy, and doctors also use MRIs to screen for cancer in some people with a high risk of developing the condition. A mammogram provides an X-ray image of the breast and can show cancerous growths that are too small to feel. The outlook for people with breast cancer has improved dramatically over the last few decades.
References: [1] I. M. Hendrick, et al., "Systematic review and meta-analysis of digital breast tomosynthesis versus digital mammography for breast cancer screening," Radiology, vol. 279, no. 3, pp. 647–657, 2016. [2] M. A. Anderson, et al., "Digital breast tomosynthesis: a review of the literature and recommendations for use," American Journal of Roentgenology, vol. 204, no. 6, pp. W753–W765, 2015. [3] C. J. D'Orsi, et al., "Radiomic analysis for breast cancer risk assessment: a systematic review and meta-analysis," Radiology, vol. 286, no. 3, pp. 695–705, 2019. [4] S. P. Kopans, "Digital breast tomosynthesis: a review of the literature," Radiology, vol. 259, no. 3, pp. 687–700, 2011. [5] S. P. Kopans, et al., "Digital breast tomosynthesis: a review of the literature and recommendations for use," American Journal of Roentgenology, vol. 204, no. 6, pp. W753–W765, 2015.
Breast cancer, a serious medical-condition, can be more effectively detected and diagnosed using Digital Breast Tomosynthesis (DBT) compared to standard mammography, as demonstrated by multiple studies. DBT reduces false positives, makes it easier to detect small anomalies, and benefits women with dense breasts, thereby providing a more accurate representation of breast health. However, DBT is relatively expensive, less widely available, and involves a slightly higher radiation dose, which may not exceed safe limits. Annual screenings for breast cancer are recommended by the American Cancer Society, and early detection and treatment significantly improve the outlook for affected individuals.
