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US and Digital Breast Tomosynthesis in Women with Focal Breast Complaints: Results of the Breast US Trial (BUST).
Appelman, Linda; Siebers, Carmen C N; Appelman, Peter T M; Go, H L Shirley; Broeders, Mireille J M; van Oirsouw, Marja C J; Bult, Peter; Mann, Ritse M.
Afiliação
  • Appelman L; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
  • Siebers CCN; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
  • Appelman PTM; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
  • Go HLS; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
  • Broeders MJM; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
  • van Oirsouw MCJ; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
  • Bult P; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
  • Mann RM; From the Department of Radiology and Nuclear Medicine (L.A., C.C.N.S., R.M.M.), Radboud Institute for Health Sciences (M.J.M.B.), and Department of Pathology (P.B.), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands; Department of Radiology, St Antonius Hospi
Radiology ; 307(4): e220361, 2023 05.
Article em En | MEDLINE | ID: mdl-37014237
ABSTRACT
Background Digital breast tomosynthesis (DBT) followed by targeted US is commonly performed to evaluate women with localized breast complaints. However, the added value of DBT in addition to targeted US is unknown. Omitting DBT may be cost-effective and improve patient comfort but may miss potential breast cancer. Purpose To assess whether an imaging protocol consisting of targeted US alone may be feasible for the diagnostic work-up of women with localized symptoms and to assess the supplemental value of DBT in this reversed setting. Materials and Methods This prospective study enrolled consecutive women aged 30 years or older with focal breast complaints in three hospitals in the Netherlands between September 2017 and June 2019. In all participants, first, targeted US was evaluated, and if needed, biopsy was performed, followed by DBT. The primary outcome was the frequency of breast cancer detected with DBT when US was negative. Secondary outcomes were frequency of cancer detected with DBT elsewhere in the breast and combined overall sensitivity of US plus DBT. The reference standard was 1 year follow-up or histopathologic examination. Results There were 1961 women (mean age ± SD, 47 years ± 12) enrolled. Based on initial US alone, 1587 participants (81%) had normal or benign findings and 1759 (90%) had a definitive accurate diagnosis. In total, 204 breast cancers were detected during initial work-up. The frequency of malignancy was 10% (192 of 1961 participants) with US (US sensitivity, 98.5% [95% CI 96, 100]; US specificity, 90.8% [95% CI 89, 92]). DBT depicted three unobserved malignant lesions at the complaint site and 0.41% (eight of 1961 participants) of incidental malignant findings in participants without symptomatic cancer. Conclusion Compared with combined US and DBT, US was accurate as a stand-alone breast imaging modality in the assessment of focal breast complaints. The rate of cancer detection of cancers elsewhere in the breast with DBT is comparable to cancer detection rate of screening mammography. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Newell in this issue.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamografia Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamografia Idioma: En Ano de publicação: 2023 Tipo de documento: Article