Stephen W. Duffy, Abstract Co-Author: Nothing to Disclose

Oliver William Edmund Morrish MSc, Abstract Co-Author: Nothing to Disclose

Lorraine Tucker, Abstract Co-Author: Nothing to Disclose

Richard Black MS, Abstract Co-Author: Nothing to Disclose

Fiona Jane Gilbert MD, Presenter: Speaker, Bracco Group Research Grant, GlaxoSmithKline plc Research Grant, General Electric Company

To assess the benefit in terms of diagnostic accuracy of addition of digital breast tomosynthesis (DBT) by breast density, as measured on a visual analogue scale and by automated volumetric software.

In a retrospective study of DBT in addition to standard full field digital mammography, we had visually assessed density on 6969 subjects (1153 cancers), Volpara automated volumetric density on 7019 subjects (1157 cancers) and Quantra automated volumetric density on 7005 subjects (1156 cancers). All subjects had mammography by 2D digital mammography alone and by 2D digital mammography plus DBT. Sensitivity and specificity was compared for between 2D mammography alone and 2D plus DBT using McNemar methods.

Median and interquartile ranges were 38% (23-50%) for visually assessed percent density, 72 cm3 (51-103) for absolute dense volume as measured by Volpara and 93 cm3 (51-143) for absolute dense volume measured by Quantra. Specificity was significantly improved with the addition of DBT in all tumours and in all subgroups as defined by breast density (p<0.001 in all cases). Sensitivity was improved significantly (p=0.03) with the addition of DBT in those subjects with visual density at or above the 3rd quartile (50%), with 86% sensitivity (95% CI 82-90%) for 2D mammography alone and 93% (95% CI 90-96%) for 2D mammography plus DBT. A significantly improved sensitivity (p=0.02) was also observed for those at or above the third quartile of Volpara density (103 cm3) Volpara, with a sensitivity of 87% (95% CI 83-91 for 2D mammography alone and 93% (95% CI 90-96%) for 2D mammography plus DBT. No significant difference in sensitivity was observed for those with high density as measured by Quantra, and no sigificant difference was observed for those with low density as measured by any of the three methods.

DBT has the potential to improve sensitivity of mammography in women with dense breast tissue.

In women with more than 50% breast density, the addition of DBT may increase cancer detection.

Duffy, S, Morrish, O, Tucker, L, Black, R, Gilbert, F, The Diagnostic Effect of Digital Breast Tomosynthesis in Relation to Visually Assessed and Automated Volumetric Breast Density.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006141.html