Mari Kikuchi MD, Presenter: Nothing to Disclose

Nachiko Uchiyama MD, Abstract Co-Author: Nothing to Disclose

Minoru Machida MD, PhD, Abstract Co-Author: Nothing to Disclose

Hitomi Tani, Abstract Co-Author: Nothing to Disclose

Takayuki Kinoshita, Abstract Co-Author: Nothing to Disclose

Yasuaki Arai, Abstract Co-Author: Nothing to Disclose

Invasive Lobular Carcinoma (ILC) is difficult to detect and to evaluate the extent of the lesion in comparison with Invasive Ductal Carcinoma among breast cancer subtypes because of its diffuse growth. Digital breast tomosynthesis (DBT) is a useful diagnostic procedure compared to 2D mammography (MMG) because overlap of breast tissue is reduced by DBT. In this study, we evaluated the diagnostic usefulness of DBT for ILC in comparison with the other diagnostic modalities; 2D MMG and contrast-enhanced MRI (CE-MRI).

Images from 32 patients (age 34-78yrs, mean 54.3yrs) who underwent 2D MMG, DBT and MRI from October 2009 to July 2013 and who were diagnosed with ILC based on surgical pathology specimens were retrospectively assessed. Items for imaging assessment were: 1. Comparison of detection capability according to 2D MMG and DBT. 2. The extent of the lesion according to 2D MMG, DBT, and MRI was compared to surgical pathology specimens, and statistical analysis was performed.

The rate of detection was 81.3% for 2D MMG and 100% for 2D MMG+DBT. Statistical analysis (using a paired t-test) revealed that adding DBT to 2D MMG significantly improved the ability to accurately diagnose the extent of the lesion compared to 2D MMG only (p<0.001, 95%CI −3.9 – −1.6). In addition, comparison of 2D MMG+DBT and MRI revealed no significant differences (p: 0.217, 95%CI −0.4–1.5), but extent of the lesion according to 2D MMG+DBT did deviate slightly from the extent of the lesion in surgical pathology specimens.

In diagnosing for ILC, adding DBT to 2D MMG resulted in improved ability to visualize tumor density, tumor margins, and architectural distortion in comparison to 2D MMG alone. Adjunction of DBT to 2D MMG is useful to detect and evaluate its extension in connection with ILC.

Adjunction of DBT to 2D MMG improves capability both to detect and assess the extent of disease for ILC and helps to reduce false-negative and to determine the treatment planning.

Kikuchi, M, Uchiyama, N, Machida, M, Tani, H, Kinoshita, T, Arai, Y, Diagnostic Usefulness of Digital Breast Tomosynthesis (DBT) for Invasive Lobular Carcinoma (ILC).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000700.html