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Positive Predictive Value of Tomosynthesis-guided Biopsies of Architectural Distortions Seen on Digital Breast Tomosynthesis and without an Ultrasound Correlate.

Authors
  • Vijayaraghavan, Gopal R1
  • Newburg, Adrienne1
  • Vedantham, Srinivasan2
  • 1 Department of Radiology, UMass School of Medicine, Worcester, Massachusetts, United States. , (United States)
  • 2 Department of Medical Imaging, The University of Arizona College of Medicine, Tucson, Arizona, United States. , (United States)
Type
Published Article
Journal
Journal of clinical imaging science
Publication Date
Jan 01, 2019
Volume
9
Pages
53–53
Identifiers
DOI: 10.25259/JCIS_134_2019
PMID: 31819830
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The objective of the study was to determine the positive predictive value (PPV) of architectural distortions (AD) observed on digital breast tomosynthesis (DBT) and without an ultrasound (US) correlate. In this single-institution, retrospective study, patients who underwent DBT-guided biopsies of AD without any associated findings on digital mammography (DM) or DBT, and without a correlate on targeted US exam, over a 14-month period were included in this study. All patients had DM and DBT and targeted US exams. The PPV was computed along with the exact 95% confidence limits (CL) using simple binomial proportions, with histopathology as the reference standard. A total of 45 ADs in 45 patients met the inclusion criteria. Histopathology indicated 6/45 (PPV: 13.3%, CL: 5.1-26.8%), ADs were malignant, including one high-risk lesion that was upgraded at surgery. ADs were appreciated only on DBT in 12/45 (26.7%) patients, and on both DBT and DM in 33/45 (73.3%) patients, and the corresponding PPV was 25% (3/12, CL: 5.5-57.2%) and 9.1% (3/33, CL: 1.9-24.3%), respectively. In all analyses, the observed PPV significantly exceeded the 2% probability of malignancy for Breast Imaging Reporting and Data System-3 diagnostic categories (P < 0.004). The PPV of malignancy in DBT detected AD without an US correlate in our series of 45 cases was 6/45 (13.3%). In the absence of an US correlate, the PPV of AD is lower than that mentioned in prior literature but exceeds the 2% threshold to justify DBT-guided biopsy. © 2019 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.

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