Scientific Session 08 — Breast - UltrasoundTuesday, May 2, 2017
3162. Comparison of Cancers Detected by Screening Ultrasound and Digital Breast Tomosynthesis
Destounis S*, Arieno A, Morgan R. Elizabeth Wende Breast Care, Rochester, NY
Address correspondence to S. Destounis (email@example.com)
Objective: The purpose of our study was to review cancers imaged with both screening US and digital breast tomosynthesis (DBT) in women with dense breasts.
Materials and Methods: During the study time period of January 2013–June 2016, a total of 9739 screening ultrasound examinations were performed in patients with heterogeneously dense or extremely dense breast tissue. Of these, 6543 also underwent DBT. These cases were reviewed retrospectively, and we identified 35 cancers diagnosed in patients imaged with both DBT and screening US. Data was collected on mode of detection, type of cancer diagnosed, tumor size, and lymph node status.
Results: A total of 35 cancers were identified in patients who underwent screening US and DBT. The majority (66%) were masses, 14% were calcifications, 9% were architectural distortion, and 11% were lymph nodes. Eighty percent of the cancers were invasive, 11% were ductal carcinoma in situ (DCIS), and 9% were not breast malignancies. Mean size at excision was 1.7 cm (range, 0.3–4.5 cm). Positive lymph nodes were found in three cases (9%). Twenty of the 35 cancers were detected on DBT, four (20%) of which were detected only by DBT. The four DBT-only cancers were all calcifications; three were DCIS and one was invasive ductal carcinoma, and three were high grade. Mean size at excision was 2.7 cm (range, 0.3-4.5 cm). Sixteen of the 35 were detected using both DBT and US; 69% were masses, 18.8% were architectural distortion, 6.3% were calcifications, and 6.3% were lymph nodes. Eighty-eight percent were invasive; 6.3% were DCIS, and 6.3% were not breast malignancies. Mean lesion size at excision was 1.9 cm (range, 0.3–4.5 cm). Positive lymph nodes were found in one case. Fifteen of 35 cancers were detected using US only; 80% were masses and 20% were lymph nodes. Eighty-seven percent were invasive and 13% were not breast malignancies. Mean lesion size at excision was 1.3 cm (range, 0.8–1.8 cm). Positive lymph nodes were found in two cases.
Conclusion: Thirty-five cancers were diagnosed in patients with dense breast tissue imaged with both DBT and US; 15 were seen using US only, 16 were seen using both DBT and US, and four were detected only using DBT. The cancers detected only on DBT were calcifications, which demonstrates a limitation of US. US allowed detection of all but one invasive carcinoma in this group. Minor differences in lesion size were observed, with smaller mean size in the US-only group. US overall performed better than DBT in identifying cancers in this study.