Scientific Session 03 — Breast - Digital Breast TomosythesisMonday, May 1, 2017
2525. Increase in Radial Scar Detection with DBT: A Benefit or Limitation of the Technology?
Destounis S*, Morgan R, Arieno A. Elizabeth Wende Breast Care, LLC., Rochester, NY
Address correspondence to S. Destounis (firstname.lastname@example.org)
Objective: The purpose of our study was to review the imaging method of detection of radial scars diagnosed at a community-based breast imaging center and to review the percent increase in the number before and after digital breast tomosynthesis (DBT) implementation.
Materials and Methods: From 2008 to 2011, our facility performed full field digital mammography (FFDM) imaging. During transition to DBT (2011–2015), hybrid imaging was performed, imaging with both DBT and FFDM. During this time, DBT was used for screening, as well as in the diagnostic evaluation of patients who were recalled on the basis of FFDM findings. We identified cases of pathology-confirmed radial scars that were detected by mammography (FFDM or DBT). All radial scar lesions diagnosed at our facility are recommended to undergo surgical excision.
Results: From 2008 to 2011 (FFDM only), a total of 46 radial scars were diagnosed. Five cases (10.9%) were upgraded to malignancy at excision. From 2012 to 2015 (FFDM and DBT), 115 radial scars were diagnosed from mammography, with 10 cases (8.7%) upgraded to malignancy at excision. During this time, 37 (32.2%) radial scars were diagnosed in patients who had screening DBT (either FFDM combined with DBT or DBT and synthetic 2D mammography) with a 5% upgrade rate. A total of 57 patients (49.5%) had screening FFDM with additional diagnostic DBT views with a 10.5% rate of upgrade. In all, 21 cases (18.3%) were imaged with screening FFDM only, with a 10% upgrade rate.
Conclusion: There was a 2.5-fold increase in detection of radial scars in the period after implementation of DBT, without an increase in upgrade to malignancy at excision. This resulted in an increase in patients referred for surgical excision for what can be considered a false-positive finding, which may be a limitation of DBT.