title: Accuracy of mammography, digital breast tomosynthesis, ultrasound and MR imaging in preoperative assessment of breast cancer.
abstract: OBJECTIVE
  To define the accuracy of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to digital mammography (DM) and ultrasound (US) in the preoperative assessment of breast cancer.
  
  
  METHODS
  We performed a prospective study of 200 consecutive women with histologically-proven breast cancer using the above imaging techniques. Accuracy measurements were estimated using a lesion-by-lesion analysis for unifocal, multifocal/multicentric, bilateral and all carcinomas. We also calculated sensitivity according to breast density.
  
  
  RESULTS
  DBT had higher sensitivity than DM (90.7% vs. 85.2%). Combined DM and DBT with US yielded a 97.7% sensitivity; despite high sensitivity of MRI (98.8%), the addition of MRI to combined DM with DBT and US did not significantly improve sensitivity. Overall accuracy did not significantly differ between MRI and DM with DBT and US (92.3% vs. 93.7%). Breast density affected sensitivity of DM and DBT (statistically significant difference for DM), not MRI.
  
  
  CONCLUSIONS
  There is little gain in sensitivity and no gain in overall accuracy, by performing MRI for patients who have been evaluated with DM with DBT and US.
authors.affiliation: Breast Imaging Service, Institute of Diagnostic and Interventional Radiology, University of Turin, Department of Diagnostic Imaging, Città della Salute e della Scienza Hospital, Via Genova 3, 10126 Turin, Italy. giovanna.mariscotti@libero.it.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mariscotti
authors.forename: Nehmat
authors.initials: N
authors.lastname: Houssami
authors.forename: Manuela
authors.initials: M
authors.lastname: Durando
authors.forename: Laura
authors.initials: L
authors.lastname: Bergamasco
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Campanino
authors.forename: Chiara
authors.initials: C
authors.lastname: Ruggieri
authors.forename: Elisa
authors.initials: E
authors.lastname: Regini
authors.forename: Andrea
authors.initials: A
authors.lastname: Luparia
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bussone
authors.forename: Anna
authors.initials: A
authors.lastname: Sapino
authors.forename: Paolo
authors.initials: P
authors.lastname: Fonio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gandini
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000601:surgery; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016217:Ultrasonography, Mammary
keywords: Breast cancer; digital breast tomosynthesis; magnetic resonance imaging; mammography