Diagnostic performance of digital breast tomosynthesis in female patients with nipple discharge

Scientific paper - Original scientific paper

• Author: Sanja Baršić Ostojić
• Author: Lora Grbanović
• Author: Ana Tonklin
• Author: Lucija Kovačević
• Author: Zlatko Marušić
• Author: Maja Prutki
• Author's institution: University of Zagreb; School of Medicine; (Department of Radiology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract (english)

Background: Nipple discharge is one of the most common symptoms related to the breast, but it is a presenting feature of breast cancer in 5%-12% of women.
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Aims: The purpose of this study was to determine the diagnostic performance of digital breast tomosynthesis (DBT) in the evaluation of patients with nipple discharge and to compare it with mammography (MMG), ultrasound (US), and magnetic resonance imaging (MRI).
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Methods and results: This retrospective study included 53 patients with nipple discharge. All patients underwent DBT, and results were compared to MMG, breast US, and MRI. Radiological findings for each method were categorized according to BI-RADS classification: categories 1-2 were considered negative and categories 3-5 positive. If a tissue specimen was obtained, the final diagnosis was established based on the results of histopathological analysis; otherwise, a clinical follow-up was required for at least 2 years to confirm benign radiological findings. Measures of diagnostic accuracy of DBT, MMG, US, and MRI were calculated and compared.
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Results: Final histopathological analysis revealed six malignant breast lesions, all of which were detected in patients with pathologic nipple discharge. DBT and MRI exhibited high sensitivity (100%) and high negative predictive value (100%) for the detection of breast cancer in patients with nipple discharge. DBT showed higher specificity compared to MRI (82.9% vs. 61.9%). Sensitivity and specificity of MMG were 83.3% and 76.6%, respectively. Breast US was determined to have a sensitivity of 66.7% and specificity of 57.5%.
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Conclusion: DBT exhibited higher specificity than MRI at the same level of sensitivity and negative predictive value. Therefore, the use of DBT should be considered as an alternative to MRI in the assessment of patients with nipple discharge.

• Keywords (english): Breast Neoplasms / diagnostic imaging; Breast Neoplasms / pathology; Female; Humans; Mammography / methods; Nipple Discharge / diagnostic imaging; Retrospective Studies; Ultrasonography, Mammary / methods
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Cancer Reports
• Numbering: vol. 5, no. 10, e1602
• p-ISSN: 2573-8348
• e-ISSN: 2573-8348
• DOI: https://doi.org/10.1002/cnr2.1602
• URN:NBN: urn:nbn:hr:105:873189
• Publication: 2022-10
• Document URL: https://onlinelibrary.wiley.com/doi/10.1002/cnr2.1602
• Type of resource: Text
• Access conditions: Open access
• Created on: 2022-10-25 09:15:41