Mary Woo Yamashita MD, Presenter: Nothing to Disclose

Sandy Chia-En Lee MD, Abstract Co-Author: Nothing to Disclose

Qinghua Min, Abstract Co-Author: Nothing to Disclose

Lingyun Ji MS, Abstract Co-Author: Nothing to Disclose

Pulin Arun Sheth MD, Abstract Co-Author: Nothing to Disclose

Susan Groshen PhD, Abstract Co-Author: Nothing to Disclose

Ingrid He, Abstract Co-Author: Nothing to Disclose

Akshara Singareeka Raghavendra MBBS, MS, Abstract Co-Author: Nothing to Disclose

Linda Hovanessian-Larsen MD, Abstract Co-Author: Nothing to Disclose

To evaluate the performance of 3D Tomosynthesis (3D Tomo) versus Contrast Enhanced MRI (CE-MRI) as an adjunct to the standard 2D mammography (2D) in detection of additional cancers in women diagnosed with breast cancer (BC).

We retrospectively reviewed available imaging, surgical, and medical records of 29 women diagnosed with BC and underwent 3D Tomo as part of their initial screening study or diagnostic imaging workup between September 2012 and January 2014. All these women had a CE-MRI prior to any surgical, medical, or radiation therapy. 3 dedicated breast imagers independently interpreted each study acquired by: 1) 2D, 2) 2D + 3D Tomo, and 3) 2D + 3D Tomo with addition of clinical history. 10 negative 2D + 3D Tomo cases were added as controls; the order of studies was randomized for each radiologist. The presence of a suspicious lesion (agreement by 2/3 radiologists) was recorded. A retrospective analysis of the CE-MRI results was performed. The gold standard was histopathology obtained by needle core biopsy and/or surgery.

Among 29 women diagnosed with BC, 48 lesions had histopathology results: 36 malignant and 12 benign. CE-MRI identified all 36 cancers but falsely identified 8 out of 12 benign lesions as suspicious. 2D identified 23 of 36 cancers (64% sensitivity) and excluded all 12 benign lesions (100% specificity). 2D + 3D Tomo identified 27 of 36 cancers (75% sensitivity) and excluded all 12 benign lesions (100% specificity). 2D + 3D Tomo with clinical information identified 32 of 36 cancers (89% sensitivity) and excluded 10 of 12 benign lesions (83% specificity).  

CE-MRI is highly sensitive in detecting invasive BC; however, its low specificity leads to unnecessary biopsies. In our pilot series, 3D Tomo mammography was found to be a valuable imaging modality for identifying additional cancers in newly diagnosed breast cancer patients with 89% sensitivity and 83% specificity.

Further investigation with a larger cohort may prove that 3D Tomo can be an alternative method of evaluating additional cancers in newly diagnosed BC patients. 

Yamashita, M, Lee, S, Min, Q, Ji, L, Sheth, P, Groshen, S, He, I, Raghavendra, A, Hovanessian-Larsen, L, Tomosynthesis 3D Mammography Compared with Contrast Enhanced Breast MRI in Pre-operative Evaluation of Patients Diagnosed with Breast Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011723.html