Breast Cancer Staging and The Role of Radiology

Ghazwani, Salha Mofareh; Rawah, Maram Adnan; Zarbah, Jaber Mohammed; Amoudi, Abdulrahman Saleh; Alyahya, Fatimah Hassan; H Aman, Abdulrahman Ahmed; Abuazzah, Raed Fuad Ahmad; Tallab, Omar Talal M; Alshammari, Amirah Ali; Akbar, Alaa Jamal A; Alharbi, Abdulrahman Abdulaziz; Alsaad, Fatimah Nasser; Al Mehdar, Amor Abdullah

doi:10.12816/0042568

Breast Cancer Staging and The Role of Radiology

Document Type : Original Article

Authors

¹ King Khalid University

² Jeddah Eye Hospital

³ Najran University

⁴ Madina Maternity and Children Hospital (MMCH)

⁵ King Abdulaziz University in Jeddah

⁶ Batterjee Medical College

⁷ Taibah University

⁸ Imam Abdulrahman Bin Faisal Hospital

⁹ Ajyad Emergency Hospital, Makkah

¹⁰ Umm Al-Qura University

¹¹ Ministry of Health

10.12816/0042568

Abstract

Purpose: To Compare tomosynthesis to mammography, ultrasound, MRI, and histology for the detection and staging of BI-RADS 4–5 anomalies, as a function of breast composition, histology, size, and lesion location.
Materials and methods: 25 patients underwent tomosynthesis, MRI, mammography, and ultrasound. The diagnostic accuracy of the different examinations was compared.
Results: The sensitivities for detection were as follows: 92.7% for MRI, 80.5% for ultrasound, 75.6% for tomosynthesis, and 61% for mammography. Tomosynthesis improves the sensitivity of mammography (P = 0.0001), but not the specificity. The detection of multifocality and multicentricity was improved, but not significantly. Tomosynthesis identified more lesions than mammography in 10% of cases and improved lesion staging irrespective of the density, but was still inferior to MRI. The detection of ductal neoplasia was superior with tomosynthesis Compared to mammography (P = 0.016), but this was not the case with lobular cancer. The visualization of masses was improved with tomosynthesis (P = 0.00012), but not with microcalcifications. Tomosynthesis was capable of differentiating lesions of all sizes, but the smaller lesions were easier to see. Lesion sizes measured with tomosynthesis, excluding the spicules, concurred with histological dimensions. Spicules lead to an overestimation of the size.
Conclusion: In our series, tomosynthesis found more lesions than mammography in 10% of patients, resulting in an adaption of the surgical plan.

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