Comparison Between Mammography, Ultrasonography and Digital Breast Tomosynthesis in Breast Cancer Size Measurement Accuracy

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Yasmin Ibrahim Libda
Inas M. Elfiki
Enas M. Khattab
Wael Elsayed Lotfy
Engy Fathy Tantawy


Background: Mammography, ultrasonography and digital breast tomosynthesis (DBT) may vary in determination of tumor size of breast tumors.

Objective: to assess the three imaging modalities (mammography, ultrasonography and DBT) regarding tumor size determination.

Methods: This study is a cross-sectional study from November 2019 to December 2021. Patients pathologically diagnosed with primary breast cancer who had available postoperative histopathological tumor measurement with preoperative examination with mammography, ultrasonography and DBT were enrolled in the study.

Results: Univariate analyses showed that the breast density (p=0.014) and tumor pathology (p=0.004) were significantly correlated with the accuracy of mammography measurements. Tumor pathology (p< 0.001) was significantly correlated with the accuracy of US and breast density (p=0.039) was significantly correlated with the accuracy of DBT measurements (less significant than mammography). The ICCs were above 0.90 Z Excellent agreement between three methods. The highest result was for DBT.

Conclusion: DBT might play an important role in the detection and measurement of breast cancer. Ultrasound and mammography tend to underestimate lesion size and mass measurements may be affected with pathological type of tumor.

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