Noguchi Naomi, Boroumand Farzaneh, Bell Katy, Pooley Margaret, Zeng Aileen, Arnold Lauren, Teixeira-Pinto Armando, Houssami Nehmat
School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Cancer Treat Res Commun. 2024;42:100865. doi: 10.1016/j.ctarc.2025.100865. Epub 2025 Jan 10.
To compare the performance of Digital Breast Tomosynthesis (DBT) with Digital Mammography (DM) in patients clinically referred for breast imaging.
Diagnostic performance of DBT (in 2016, after transition to DBT) was compared with DM (in 2011, before the transition) in consecutively referred patients (N = 10,742 exams). Reference standard was outcomes from all tests including histopathology and clinical review within the same year. Primary outcome was area under receiver operating characteristic curve (AUC-ROC).
Cancer rates did not differ between DBT (1.72 % (CI 1.38-2.15 %)) and DM (1.71 % (CI 1.40-2.08 %)). AUC-ROC was similar for DBT (0.91 (CI 0.87-0.95)) and DM (CI 0.91 (0.88-0.95)). Abnormal interpretation rate for DBT was 2.83 % (CI 2.38-3.36 %) and for DM it was 2.17 % (CI 1.82-2.58 %), and the biopsy rate for DBT was 8.2 % (CI 7.4-9.0 %) and for DM it was 9.9 % (CI 9.1-10.6 %)). In patients with dense breasts (vs overall cohort) AUC-ROC and sensitivity were lower for both DM and DBT. Within this subgroup, AUC-ROC for DBT was 0.90 (CI 0.84-0.95) and for DM it was 0.85 (CI 0.79-0.92), sensitivity was 78.2 % (CI 65.0-88.2 %) for DBT and 64.8 % (CI 50.6-77.3 %) for DM, and ultrasound was accurate whether it was used with DBT (AUC-ROC 0.95 (CI 0.91 - 0.99)) or DM (AUC-ROC 0.95 (CI 0.90 - 0.99)) CONCLUSION: In clinically referred patients, diagnostic accuracy and diagnostic yield were similar between DBT and DM. DBT may have a higher abnormal interpretation rate but a lower biopsy rate. DBT may be more accurate than DM in dense breasts.
比较数字乳腺断层合成（DBT）与数字乳腺X线摄影（DM）在临床转诊进行乳腺成像的患者中的表现。
将DBT（2016年，转为DBT后）与DM（2011年，转为DBT前）在连续转诊患者（N = 10742次检查）中的诊断性能进行比较。参考标准为同一年内所有检查（包括组织病理学和临床复查）的结果。主要结局为受试者操作特征曲线下面积（AUC-ROC）。
DBT（1.72%（CI 1.38 - 2.15%））和DM（1.71%（CI 1.40 - 2.08%））的癌症检出率无差异。DBT（0.91（CI 0.87 - 0.95））和DM（CI 0.91（0.88 - 0.95））的AUC-ROC相似。DBT的异常解读率为2.83%（CI 2.38 - 3.36%），DM为2.17%（CI 1.82 - 2.58%），DBT的活检率为8.2%（CI 7.4 - 9.0%），DM为9.9%（CI 9.1 - 10.6%）。在乳腺致密的患者（与总体队列相比）中，DM和DBT的AUC-ROC及敏感性均较低。在该亚组中，DBT的AUC-ROC为0.90（CI 0.84 - 0.95），DM为0.85（CI 0.79 - 0.92），DBT的敏感性为78.2%（CI 65.0 - 88.2%），DM为64.8%（CI 50.6 - 77.3%），并且无论与DBT（AUC-ROC 0.95（CI 0.91 - 0.99））还是DM（AUC-ROC 0.95（CI 0.90 - 0.99））联合使用，超声都具有较高的准确性。结论：在临床转诊患者中，DBT和DM的诊断准确性和诊断率相似。DBT可能具有较高的异常解读率，但活检率较低。在乳腺致密的患者中，DBT可能比DM更准确。
