Comparison of ultrasound and digital mammography plus tomosynthesis in determining benign and malignant breast lesions using pathology as a gold standard, in 102 Chinese women.

OBJECTIVE: This study was to evaluate performance characteristics of ultrasonography (US) and a combined two-and three-dimensional (2D+3D) digital mammography in identifying breast tumors in Chinese women.

SUBJECTS AND METHODS: One hundred and two women with suspected breast tumors were examined using diagnostic imaging techniques of US and a combined 2D+3D imaging protocol. Detection of breast tumors in women with and without dense breasts was validated according to the features of image-detected breast tumors which were proven by histological exam in this study cohort.

RESULTS: Breast US was superior to 2D+3D imaging in assessing benign lesions (P<0.01). The diagnostic measure on 2D+3D mammography was more accurate than the US exam in breast cancer detection. Furthermore, 2D+3D imaging was more sensitive than US in identifying malignant lesions in size of ≤1cm and in relatively high breast density (P<0.01 or 0.05). Breast US showed a better correlation with the sizes of benign tumor as compared to 2D+3D imaging with correlation coefficients of 0.930 and 0.920. Conversely, 2D+3D imaging showed a better correlation with the sizes of malignant tumors as compared to US with correlation coefficients of 0.951 and 0.815. Additionally, presence of microcalcifications on mammography significantly increased in breast cancers as compared to benign tumors (P<0.001).

CONCLUSION: Breast US and 2D+3D mammography imaging play an additive role in identifying breast tumors. Intervention of the 2D+3D imaging technique helps recognize appearance and characteristics of breast lesions particularly in the women with a lesion measure of ≤1cm and those with dense breasts or breast microcalcifications.