title: Value of one-view breast tomosynthesis versus two-view mammography in diagnostic workup of women with clinical signs and symptoms and in women recalled from screening.
abstract: OBJECTIVE
  The purpose of this study is to compare the diagnostic value of one-view digital breast tomosynthesis versus two-view full-field digital mammography (FFDM) alone, and versus a combined reading of both modalities.
  
  
  METHODS
  The datasets of one-view digital breast tomosynthesis and two-view FFDM of abnormal mammograms in 144 consecutive women admitted for diagnostic workup with clinical signs and symptoms (n = 78) or recalled from screening (n = 66) were read alone and in a combined setting. The malignant or benign nature of the lesions was established by histologic analysis of biopsied lesions or by 12-16-month follow-up.
  
  
  RESULTS
  Eighty-six of the 144 patients were found to have breast cancer. The BI-RADS categories for one-view digital breast tomosynthesis were significantly better than those for two-view FFDM (p < 0.001) and were equal to those of the combined reading in both women admitted for diagnostic workup and women recalled from screening. The sensitivity and negative predictive values of digital breast tomosynthesis were superior to those of FFDM in fatty and dense breasts overall and in women admitted for diagnostic workup and in women recalled from screening. Only 11% of digital breast tomosynthesis examinations required additional imaging, compared with 23% of FFDMs.
  
  
  CONCLUSIONS
  In patients with abnormal mammograms, one-view digital breast tomosynthesis had better sensitivity and negative predictive value than did FFDM in patients with fatty and dense breasts. They also suggest that digital breast tomosynthesis would likely increase the predictive values if incorporated in routine screening.
authors.affiliation: Division of Radiology, Breast Center Bern, Klinik Engeried, Sonnenhof AG, Riedweg 15, 3012 Bern, Switzerland. christianwaldherr@sonnenhof.ch
authors.forename: Christian
authors.initials: C
authors.lastname: Waldherr
authors.forename: Peter
authors.initials: P
authors.lastname: Cerny
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Altermatt
authors.forename: Gilles
authors.initials: G
authors.lastname: Berclaz
authors.forename: Michele
authors.initials: M
authors.lastname: Ciriolo
authors.forename: Katharina
authors.initials: K
authors.lastname: Buser
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Sonnenschein
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity