Digital breast tomosynthesis versus full-field digital mammography-Which modality provides more accurate prediction of margin status in specimen radiography?
Eur J Radiol
; 93: 258-264, 2017 Aug.
Article
em En
| MEDLINE
| ID: mdl-28668424
ABSTRACT
OBJECTIVES:
To evaluate the reliability of tumor margin assessment in specimen radiography (SR) using digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in comparison to postoperative histopathology margin status as the gold standard.METHODS:
After ethics committee approval, 102 consecutive patients who underwent breast conservative surgery for nonpalpable proven breast cancer were prospectively included. All patients underwent ultrasound/mammography-guided wire localization of their lesions. After excision, each specimen was marked for orientation and imaged using FFDM and DBT. Two blinded radiologists (R1, R2) independently analyzed images acquired with both modalities. Readers identified in which direction the lesion was closest to the specimen margin and to measure the margin width. Their findings were compared with the final histopathological analysis. True positive margin status was defined as a margin measuring <1mm for invasive cancer and 5mm for ductal carcinoma in situ (DCIS) at imaging and pathology.RESULTS:
For FFDM, correct margin direction was identified in 45 cases (44%) by R1 and in 37 cases (36%) by R2. For DBT, 69 cases (68%) were correctly identified by R1 and 70 cases (69%) by R2. Overall accuracy was 40% for FFDM and 69% for DBT; the difference was statistically significant (p<0.0001). Sensitivity in terms of correct assessment of margin status was significantly better for DBT than FFDM (77% versus 62%).CONCLUSION:
SR using DBT is significantly superior to FFDM regarding identification of the closest margin and sensitivity in assessment of margin status.Palavras-chave
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Bases de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
/
Carcinoma Intraductal não Infiltrante
Tipo de estudo:
Evaluation_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
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Middle aged
Idioma:
En
Revista:
Eur J Radiol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Alemanha