title: The role of tomosynthesis in breast cancer staging in 75 patients.
abstract: OBJECTIVE
  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, lesion location, size, and histology.
  
  
  METHODS
  Seventy-five patients underwent mammography, tomosynthesis, ultrasound, and MRI. The diagnostic accuracy of the different examinations was compared.
  
  
  RESULTS
  The sensitivities for detection were as follows: 92.5% with MRI, 79% for ultrasound, 75% for tomosynthesis, and 59.5% for mammography. Tomosynthesis improves the sensitivity of mammography (P=0.00013), 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 than with 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 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.
  
  
  CONCLUSIONS
  In our series, tomosynthesis found more lesions than mammography in 10% of patients, resulting in an adaption of the surgical plan.
authors.affiliation: Service de sénologie et imagerie du sein, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Mercier
authors.affiliation: ERTICA EA 4677, université d'Auvergne, 63000 Clermont-Ferrand, France; Centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: F
authors.initials: F
authors.lastname: Kwiatkowski
authors.affiliation: ERTICA EA 4677, université d'Auvergne, 63000 Clermont-Ferrand, France; Centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Abrial
authors.affiliation: Service de sénologie et imagerie du sein, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: V
authors.initials: V
authors.lastname: Boussion
authors.affiliation: Service de sénologie et imagerie du sein, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: V
authors.initials: V
authors.lastname: Dieu-de Fraissinette
authors.affiliation: Service de sénologie et imagerie du sein, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: W
authors.initials: W
authors.lastname: Marraoui
authors.affiliation: Service de sénologie et imagerie du sein, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: V
authors.initials: V
authors.lastname: Petitcolin-Bidet
authors.affiliation: Service de sénologie et imagerie du sein, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France. Electronic address: Sylvie.LEMERY@cjp.fr.
authors.forename: S
authors.initials: S
authors.lastname: Lemery
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D018567:Breast Neoplasms, Male / Q000175:diagnosis; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D016217:Ultrasonography, Mammary
keywords: Breast; Multicentricity; Multifocality; Staging; Tomosynthesis