title: Significance and Application of Digital Breast Tomosynthesis for the BI-RADS Classification of Breast Cancer.
abstract: BACKGROUND
  Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization overlapping and provide more reliable images for BI-RADS classification. This study aims to explore application of COMBO (FFDM+DBT) for effect and significance of BI-RADS classification of breast cancer.
  
  
  METHODS
  In this study, we selected 832 patients who had been treated from May 2013 to November 2013. Classify FFDM and COMBO examination according to BI-RADS separately and compare the differences for glands in the image of the same patient in judgment, mass characteristics display and indirect signs. Employ Paired Wilcoxon rank sum test was used in 79 breast cancer patients to find differences between two examine methods.
  
  
  RESULTS
  The results indicated that COMBO pattern is able to observe more details in distribution of glands when estimating content. Paired Wilcoxon rank sum test showed that overall classification level of COMBO is higher significantly compared to FFDM to BI-RADS diagnosis and classification of breast (P<0.05). The area under FFDM ROC curve is 0.805, while that is 0.941 in COMBO pattern. COMBO shows relation of mass with the surrounding tissues, the calcification in the mass, and multiple foci clearly in breast cancer tissues. The optimal sensitivity of cut-off value in COMBO pattern is 82.9%, which is higher than that in FFDM (60%). They share the same specificity which is both 93.2%.
  
  
  CONCLUSIONS
  Digital Breast Tomosynthesis (DBT) could be used for the BI-RADS classification in breast cancer in clinical.
authors.affiliation: Department of Imaging, the Second Clinical College of Fujian Medical University, Quanzhou, Fujian Province, China E-mail : caisiqingqz@yeah.net.
authors.forename: Si-Qing
authors.initials: SQ
authors.lastname: Cai
authors.forename: Jian-Xiang
authors.initials: JX
authors.lastname: Yan
authors.forename: Qing-Shi
authors.initials: QS
authors.lastname: Chen
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Huang
authors.forename: Dong-Lu
authors.initials: DL
authors.lastname: Cai
mesh_terms: D001940:Breast / Q000002:abnormalities* / Q000473:pathology; D001943:Breast Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging* / Q000473:pathology; D016022:Case-Control Studies; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D014056:Tomography, X-Ray