[Value of digital breast tomosynthesis (DBT) in the diagnosis of breast lesions].

Objective: To assess the value of digital breast tomosynthesis (DBT) in the diagnosis of breast lesions. Methods: Two hundred and fifty-three breast lesions in 250 patients were selected in this study. All lesions were confirmed pathologically. Preoperative diagnosis was performed independently with full-field digital mammography (FFDM), DBT and DBT plus FFDM, respectively. The diagnostic value of DBT for breast lesions was evaluated based on the pathological diagnosis as the gold standard. The diagnostic performance of DBT and FFDM for breast lesions was compared between the groups with different ages, mammary gland densities and hormone levels. The sensitivity of DBT and FFDM was compared between the groups with different pathological types and different sizes of breast cancer. The correlation between the longest diameter of breast cancers and pathological measurements shown on DBT and FFDM was analyzed. Results: The areas under ROC curves were 0.890, 0.833 and 0.890 for DBT, FFDM and DBT plus FFDM, respectively. The areas under ROC curves for DBT or DBT plus FFDM were significantly greater than that for FFDM (P<0.05). In the group with breast density>50%, group with age ≤50 and non-menopause group, all the areas under ROC curves for DBT or DBT plus FFDM were all significantly larger than that for FFDM (P<0.05). No significant differences were observed in the group with breast density ≤50%, group with age>50 and menopause group (P>0.05). The sensitivity for both DBT and FFDM in the diagnosis of carcinoma in situ was 90.9% (10/11). The sensitivity for DBT and FFDM in the diagnosis of non-carcinoma in situ was 92.3% (120/130) and 83.8% (109/130), respectively. The sensitivity in the groups with the longest diameter of foci >0 mm but ≤10 mm, >10 mm but ≤20 mm, >20 mm but ≤30 mm, and >30 mm but ≤40 mm were 51.7% (4/7), 93.8% (61/65), 96.7% (30/31) and 100% (11/11), respectively, for DBT, and were 51.7% (4/7), 78.5% (51/65), 93.5% (29/31), and 100% (11/11), respectively, for FFDM. The correlation coefficients between the longest diameter of breast cancers and pathological measurements shown on DBT and FFDM were 0.905 and 0.849, respectively (P<0.001). Conclusions: Compared with FFDM, DBT shows a higher diagnostic efficiency in patients with breast density >50%, age ≤50 years and non-menopause, non-carcinoma in situ, and the longest diameter of lesions >10 mm but ≤ 20 mm. The longest diameter of breast lesions is more accurately shown on DBT.