Destounis Stamatia, Arieno Andrea, Morgan Renee
Elizabeth Wende Breast Care, Rochester, New York.
J Clin Imaging Sci. 2014 Feb 25;4:9. doi: 10.4103/2156-7514.127838. eCollection 2014.
Initial review of patients undergoing screening mammography imaged with a combination of digital breast tomosynthesis (DBT) plus full field digital mammography (FFDM) compared with FFDM alone.
From June 2011 to December 2011, all patients presenting for routine screening mammography were offered a combination DBT plus FFDM exam. Under institutional review board approval, we reviewed 524 patients who opted for combination DBT plus FFDM and selected a sample group of 524 FFDM screening exams from the same time period for a comparative analysis. The χ(2) (Chi-square) test was used to compare recall rates, breast density, personal history of breast cancer, and family history of breast cancer between the two groups.
Recall rate for FFDM, 11.45%, was significantly higher (P < 0001) than in the combination DBT plus FFDM group (4.20%). The biopsy rate in the FFDM group was 2.29% (12/524), with a cancer detection rate of 0.38% (2/524, or 3.8 per 1000) and positive predictive value (PPV) of 16.7% (2/12). The biopsy rate for the DBT plus FFDM group was 1.14% (n = 6/524), with a cancer detection rate 0.57% (n = 3/524, or 5.7 per 1000) and PPV of 50.0% (n = 3/6). Personal history of breast cancer in the FFDM group was significantly lower (P < 0.0001) than in the combination DBT plus FFDM group; 2.5% and 5.7%, respectively. A significant difference in family history of breast cancer (P < 0.0001) was found, with a higher rate in the combination DBT plus FFDM group (36.0% vs. 53.8%). There was a significant difference between the combination DBT plus FFDM group and FFDM alone group, when comparing breast density (P < 0.0147, 61.64% vs. 54.20% dense breasts, respectively) with a higher rate of dense breasts in the DBT plus FFDM group. In follow-up, one cancer was detected within one year of normal screening mammogram in the combination DBT plus FFDM group.
Our initial experience found the recall rate in the combination DBT plus FFDM group was significantly lower than in the FFDM alone group, despite the fact that the combination DBT plus FFDM group had additional risk factors.
初步评估接受乳腺数字断层合成（DBT）与全视野数字乳腺摄影（FFDM）联合成像筛查的患者，并与仅接受FFDM成像的患者进行比较。
2011年6月至2011年12月期间，所有前来进行常规乳腺筛查的患者均接受DBT与FFDM联合检查。经机构审查委员会批准，我们对524例选择DBT与FFDM联合检查的患者进行了回顾，并从同一时期选择了524例FFDM筛查检查作为样本组进行对比分析。采用χ²（卡方）检验比较两组之间的召回率、乳腺密度、个人乳腺癌病史及乳腺癌家族史。
FFDM的召回率为11.45%，显著高于DBT与FFDM联合检查组（4.20%）（P<0.0001）。FFDM组的活检率为2.29%（12/524），癌症检出率为0.38%（2/524，即每1000例中有3.8例），阳性预测值（PPV）为16.7%（2/12）。DBT与FFDM联合检查组的活检率为1.14%（n = 6/524），癌症检出率为0.57%（n = 3/524，即每1000例中有5.7例），PPV为50.0%（n = 3/6）。FFDM组的个人乳腺癌病史显著低于DBT与FFDM联合检查组（P<0.0001），分别为2.5%和5.7%。乳腺癌家族史存在显著差异（P<0.0001），DBT与FFDM联合检查组的比例更高（36.0%对53.8%）。在比较乳腺密度时，DBT与FFDM联合检查组和仅接受FFDM检查组之间存在显著差异（P<0.0147，致密乳腺的比例分别为61.64%对54.20%），DBT与FFDM联合检查组致密乳腺的比例更高。在随访中，DBT与FFDM联合检查组有1例癌症在正常乳腺筛查钼靶检查后1年内被检出。
我们的初步经验发现，尽管DBT与FFDM联合检查组存在更多风险因素，但其召回率显著低于仅接受FFDM检查组。
