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Abstract：
The diagnostic performance difference between digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) for breast suspicious calcifications from various populations is unclear. The objective of this study is to determine whether DBT exhibits the diagnostic advantage for breast suspicious calcifications from various populations compared with FFDM. Three hundred and five patients were enrolled (of which seven patients with bilateral lesions) and 312 breasts images were retrospectively analyzed by three radiologists independently. The postoperative pathology of breast calcifications was the gold standard. Breast cancer was diagnosed utilizing DBT and FFDM with sensitivities of 92.9% and 88.8%, specificities of 87.9% and 75.2%, positive predictive values of 77.8% and 62.1%, negative predictive values of 96.4% and 93.6%, respectively. DBT exhibited significantly higher diagnostic accuracy for benign calcifications compared with FFDM (87.9% vs 75.2%), and no advantage in the diagnosis of malignant calcifications. DBT diagnostic accuracy was notably higher than FFDM in premenopausal (88.4% vs 78.8%), postmenopausal (90.2% vs 77.2%), and dense breast cases (89.4% vs 81.9%). There was no significant difference in non-dense breast cases. In our study, DBT exhibited a superior advantage in dense breasts and benign calcifications cases compared to FFDM, while no advantage was observed in non-dense breasts or malignant calcifications cases. Thus, in the breast cancer screening for young women with dense breasts, DBT may be recommended for accurate diagnosis. Our findings may assist the clinicians in applying the optimal techniques for different patients and provide a theoretical basis for the update of breast cancer screening guideline.
摘要：
数字乳腺断层摄影（DBT）和常规全视野数字乳腺X线摄影（FFDM）对不同人群的乳腺可疑钙化的诊断性能差异尚不清楚。这项研究的目的是确定与FFDM相比，DBT是否对各种人群的乳腺可疑钙化具有诊断优势。纳入了三百零五例患者（其中七例双侧病变），三名放射科医生对312例乳房图像进行了回顾性分析。术后乳腺钙化病理是金标准。使用DBT和FFDM诊断乳腺癌的敏感性为92.9％和88.8％，特异性为87.9%和75.2%，阳性预测值为77.8%和62.1%，阴性预测值为96.4%和93.6%，分别。与FFDM相比，DBT对良性钙化的诊断准确性明显更高（87.9％vs75.2％）。在恶性钙化的诊断中没有优势。DBT诊断准确率明显高于绝经前的FFDM（88.4%vs78.8%）。绝经后（90.2%vs77.2%），和致密乳腺病例（89.4%vs81.9%）。在非致密乳腺病例中没有显着差异。在我们的研究中,与FFDM相比，DBT在致密乳房和良性钙化病例中表现出优越的优势。而在非致密乳房或恶性钙化病例中没有观察到优势。因此，在乳房致密的年轻女性的乳腺癌筛查中，建议DBT进行准确诊断。我们的发现可以帮助临床医生针对不同患者应用最佳技术，并为乳腺癌筛查指南的更新提供理论依据。
