Digital Breast Tomosynthesis as a Tool to Reduce False-Positive Mammography Results: a Comparative Analysis of Diagnostic Accuracy

Background . The growing interest in digital breast tomosynthesis (DBT) is due to its ability to significantly reduce the false-positive rate of mammography due to layer-by-layer imaging, which provides a more detailed analysis of tissue structural features. Objective: to evaluate the effectiveness of DBT in reducing the rate of false-positive mammography results. Material and methods . The data of 82 patients with BI-RADS category 4 on 2D mammography who underwent DBT using Fujifilm FDR MS-3500 device (high resolution mode, slice thickness 1 mm) were retrospectively analyzed. If the detected changes were classified as BI-RADS 4–5 by DBT, a stereotactic biopsy with histological verification was performed. An analysis of the consistency between DBT and mammography in the classification of pathological changes in the BI-RADS category was carried out, as well as an assessment of the positive prognostic value of 2D mammography and DBT. Results . DBT reclassified BI-RADS 4 determined by mammography results to BI-RADS 2 in 59% of cases and to BI-RADS 3 in 8.5% of cases. The positive prognostic value for mammography was 17.1%, for DBT it was 53.8%. In patients with radiologically dense mammary glands (ACR C, D), in 66.7% of cases, BI-RADS 4 were reclassified into BI-RADS 2–3. Conclusion . DBT was proven to be superior to standard mammography in accurately classifying masses according to BI-RADS categories, including in patients with high breast density, providing detailed visualization of the architectonics of pathologies and reducing the incidence of false positives.