title: Added value of one-view breast tomosynthesis combined with digital mammography according to reader experience.
abstract: OBJECTIVE
  To retrospectively evaluate the added value of one-view breast tomosynthesis in adjunct with mammography to characterize breast lesions.
  
  
  METHODS
  Our institutional ethics committees approved the study and granted a waiver of informed consent. One hundred fifty-five women (mean age, 51.3 years, range: 24-92 years) who systematically underwent mammography and breast tomosynthesis with subsequent percutaneous biopsy were analyzed. Four radiologists (two seniors, R1 and R2, and two juniors, R3 and R4 with 30, 10, 3 and 1 years of experience in breast imaging, respectively) independently reviewed exams in two steps: mammography alone and tomosynthesis in adjunct with mammography. The lesions in the cohort included 39.3% (61/155) cancers, 2.5% (4/155) high-risk lesions and 58.1% (90/155) benign lesions. A receiver operating characteristic (ROC) curve analysis was performed to compare the results of the two readings.
  
  
  RESULTS
  There was almost perfect agreement irrespective of reader experience for the reading of the mammography in adjunct with tomosynthesis, whereas agreement was poor between junior and senior readers for the reading of mammography alone. Area under the ROC (Az) values for the tomosynthesis in adjunct with mammography were significantly better than Az values for mammography alone for all readers except the most experienced, for whom only a tendency was noted. The proportion of cancers undiagnosed by mammography alone that were well diagnosed by tomosynthesis in adjunct with mammography was 6.5% (4/61), 13.1% (8/61), 27.8% (17/61) and 26.2% (16/61) for Readers 1, 2, 3 and 4, respectively. The proportion of false positive cases induced by the addition of breast tomosynthesis to mammography was 2.1% (2/94), 2.1% (2/94), 9.5% (9/94) and 12.7% (12/94) for Readers 1, 2, 3 and 4, respectively.
  
  
  CONCLUSIONS
  Adding breast tomosynthesis to mammography improved sensitivity and negative predictive value for all readers except for the most experienced one, in whom only a tendency for improvement was noted.
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris, France; INSERM, UMR970, Equipe 2, Imagerie de l'angiogenèse, 75005 Paris, France; AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris, France. Electronic address: isabelle.thomassin@tnn.aphp.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thomassin-Naggara
authors.affiliation: AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris, France; Centre Pyramides, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Perrot
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, IUC, 75005 Paris, France; AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Dechoux
authors.affiliation: Centre Pyramides, Paris, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Ribeiro
authors.affiliation: AP-HP, Hôpital Tenon, Department of Radiology, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Chopier
authors.affiliation: APHP, Department of Radiology, Hôpital Saint Louis, 75010 Paris, France.
authors.forename: Cedric
authors.initials: C
authors.lastname: de Bazelaire
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D012015:Reference Standards; D012189:Retrospective Studies; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed
keywords: Breast tomosynthesis; Cancer; Diagnosis; Mammography