Applications of Advanced Breast Imaging Modalities.

PURPOSE OF REVIEW: Advanced mammographic imaging modalities have been implemented in clinical practices throughout the USA. The most notable and widely used has been the three-dimensional derivative of digital mammography, known as digital breast tomosynthesis (DBT). In this article, we review the screening and diagnostic applications of DBT, along with its limitations. We also briefly address several supplemental breast imaging modalities.

RECENT FINDINGS: The accumulating evidence from both small and large-scale trials has shown a significant reduction in recall rates and slight increase in cancer detection rates when using DBT. However, the incremental increase in cancers detected remains less than that achieved with several supplemental imaging modalities, including whole-breast ultrasound, MRI, and MBI (molecular breast imaging). Other modalities, such as CEM (contrast-enhanced mammography) and CET (contrast-enhanced tomography), are also being investigated. Numerous studies have confirmed the added value of DBT and its increased cancer detection rate in both the screening and diagnostic settings. However, the superior sensitivity of supplemental imaging modalities renders them essential, especially in high-risk patients, and potentially those with dense breasts.