Abstract
OBJECTIVE: To investigate the sensitivity and specificity of digital mammography (DM) and digital breast tomosynthesis (DBT) for the detection of breast cancer in comparison to histopathology findings. SUBJECTS AND METHODS: We included 65 breast lesions in 58 women, each detected by two diagnostic mammography techniques - DM and DBT using Senographe Essential (GE Healthcare, Buc, France) - and subsequently confirmed by histopathology. The Breast Imaging Reporting and Data System was used for characterizing the lesions. RESULTS: The average age of women was 48.3 years (range 26-81 years). There were 34 malignant and 31 benign breast lesions. The sensitivity of DM and DBT was 73.5 and 100%, respectively, while the specificity was 67.7 and 94%, respectively. Receiver operating characteristic curve analysis showed an overall diagnostic advantage of DBT over DM, with a significant difference between DBT and DM (p < 0.001). By performing Cohen's kappa test, we found that there was a strong level of agreement according to Altman guidelines between DBT and histopathology findings (0.97), but a weak agreement between DM and histopathology findings (0.47). CONCLUSION: DBT improves the clinical accuracy of mammography by increasing both sensitivity and specificity. We believe that this improvement is due to improved image visibility and quality. These results could be of interest to health care institutions as they may impact their decision on whether to upgrade to DBT not only for diagnosis, but also for screening.