2427 women (mean age 60.0 years; range 20-94 years) were screened with DBT and ABVS from May 2014 to December 2018. 5375 women (mean age 57.3 years; range 40-84 years) were screened with MMG and HUS from February 2004 to December 2013. Number of recall cases (rate), unidentified cases, further exams, identified outcome cases, breast cancer cases, false positive cases, positive predictive value (PPV), cancer detection rate, implementation rate of further exams (fine needle aspiration (FNA), core needle biopsy (CNB), vacuum-assisted breast biopsy(VAB)) were evaluated between two groups. The recall rate was lower in women with DBT and ABVS in comparison with women with MMG and HUS (7.9 % vs 8.2%; p>0.05). Detection rate of breast cancers was higher in women with DBT and ABVS than women with MMG and HUS (1.6% vs 1.2%; p>0.05). Non-cancer rate among women receiving invasive procedures was lower in women with DBT and ABVS in comparison with women with MMG and HUS (0.9% vs 1.0%; p>0.05). PPV was significantly higher in women with DBT and ABVS in comparison with women with MMG and HUS (19.9% vs 14.5%; p=0.045). DBT and ABVS screening improved the cancer detection rate with significant higher PPV in comparison with MMG and HUS for breast cancer screening.
KEYWORDS: Digital breast tomosynthesis, Positron emission tomography, Magnetic resonance imaging, Diagnostics, Cancer, Breast, Image fusion, Breast cancer, Tumors
Twenty-six patients with 27 invasive breast cancers were enrolled and MMG+DBT, US, and PETMR were obtained before and after NAC. The clinical response to chemotherapy was classified into the following categories, based on the RECIST and pathological response was classified in accordance with JBCS. Among Grade 3 (n=7), MMG+DBT demonstrated as CR by 71.4% and as PR by 28.6%. Among PR lesions, estimated pathological response was Grade 2 (n=2). PETMR demonstrated as PR by 57.1% and as CR by 42.9%. Among PR lesions, estimated pathological response was Grade 2 (n=4). FDG uptake was positive before and negative after NAC with all primary lesions. Among Grades 1b-2 (n=15), MMG +DBT demonstrated as PR by 76.3% (n=11) and four as CR by 26.7% (n=4). Among PR lesions, estimated pathological response were Grade 1b (n=5) and Grade 2 (n=6). PETMR demonstrated as PR by 80.0% and as CR by 20.0%. Among PR lesions, estimated pathological response were Grade 1b (n=3) and Grade 2 (n=9). After NAC, FDG uptake was positive in primary lesions by 20.0% (n=3). Among Grade 0-1a (n=5), MMG+DBT demonstrated as SD by 60.0 % and as PR by 40.0%. Among PR lesions, estimated pathological response were Grade 1b (n=1) and Grade 2 (n=1). PETMR demonstrated as SD by 40.0 % and as PR by 60.0%. Among PR lesions, estimated pathological response were Grade 1b (n=2) and Grade 2 (n=1). After NAC, FDG uptake was positive in primary lesions by 80.0% (n=4).
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