Could Breast Tomosynthesis With Synthetic View Mammography Aid Standard Two-Dimensional Mammography in Evaluation at Symptomatic Triple Assessment Breast Clinics?

Background This study aimed to determine whether breast tomosynthesis and synthetic view mammography (SM) can aid standard two-dimensional mammography (S2DM) in the evaluation of symptomatic women at triple assessment clinics (TACs). Methodology Digital breast tomosynthesis (DBT), SM, and S2DM were performed on 400 patients at symptomatic breast TACs between September 2020 and November 2020. Diagnostic findings on mammography and ultrasound were retrospectively recorded and analyzed by a breast-trained radiologist with 13 years of clinical experience. Pathology results for all biopsies were recorded and correlated with the mammographic and ultrasound findings. Results The combination of DBT and SM was superior to S2DM in the following settings: calcifications were more conspicuous on SM than S2DM in 44% of patients with calcifications. Mass margins were better defined on DBT than S2DM in 71% of patients with masses. Distortion was more easily detectable in 11% of patients with distortion on SM and in 44% of patients with distortion on DBT compared with S2DM. All malignant lesions were identified on all modalities. Conclusions Combined DBT and SM demonstrated several advantages over S2DM alone. SM can provide equal and sometimes superior diagnostic performance with the added benefit of requiring no additional radiation exposure when synthesized from DBT data. We conclude that adding DBT and SM to S2DM aids in the assessment of symptomatic women, and omitting S2DM results in no loss of clinically relevant information for women presenting to symptomatic breast clinics.