Imaging characteristics and features suggestive of malignancy in breast lesions on digital breast tomosynthesis
Main Article Content
Abstract
Breast cancer is a common malignancy in women, and digital breast tomosynthesis (DBT) is increasingly used for the detection and characterization of breast lesions. This cross-sectional study of 101 patients with 113 histopathologically confirmed lesions (May 2024 to July 2025) showed that suspicious calcifications, increased-density asymmetry, and architectural distortion were more frequently observed in malignant lesions than in benign lesions (p < 0.05). Among mass lesions, malignant tumors more commonly exhibited an irregular shape, spiculated or indistinct margins, and high density compared with benign tumors (p < 0.001). Multivariable analysis showed that the presence of a mass, suspicious calcifications, and asymmetry remained statistically significant after adjustment. Within the subgroup of mass lesions, spiculated or indistinct margins and high density also remained statistically significant after adjustment. These findings suggest that DBT has value in identifying several imaging features suggestive of breast malignancy.
Article Details
Keywords
digital breast tomosynthesis, breast lesions, malignancy, imaging features
References
2. Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. International Agency for Research on Cancer. https://gco.iarc.who.int/today. Updated April 4, 2026. Accessed April 01, 2026.
3. Marcon M, Fuchsjäger MH, Clauser P, et al. ESR Essentials: screening for breast cancer-general recommendations by EUSOBI. Eur Radiol. 2024;34(10):6348-6357. doi:10.1007/s00330-024-10740-5
4. Dhamija E, Gulati M, Deo SVS, et al. Digital breast tomosynthesis: an overview. Indian J Surg Oncol. 2021;12(2):315-329. doi:10.1007/s13193-021-01310-y
5. Olinder J, Johnson K, Åkesson A, et al. Impact of breast density on diagnostic accuracy in digital breast tomosynthesis versus digital mammography: results from a European screening trial. Breast Cancer Res. 2023;25(1):116. doi:10.1186/s13058-023-01712-6
6. Alabousi M, Wadera A, Kashif Al-Ghita M, et al. Performance of Digital Breast Tomosynthesis, Synthetic Mammography, and Digital Mammography in Breast Cancer Screening: A Systematic Review and Meta-Analysis. J Natl Cancer Inst. 2021;113(6):680-690. doi:10.1093/jnci/djaa205
7. Lei J, Yang P, Zhang L, et al. Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis. Eur Radiol. 2014;24(3):595-602. doi:10.1007/s00330-013-3012-x
8. American College of R. ACR BI-RADS® Atlas: Breast Imaging Reporting and Data System. 5th ed. American College of Radiology; 2013.
9. Trần Lê Minh Nguyệt, Nguyễn Phước Bảo Quân, Trần Thị Nam Phương, và cs. Nghiên cứu đặc điểm mô bệnh học, hình ảnh và giá trị của siêu âm, nhũ ảnh tổn thương tuyến vú BI-RADS 4. Tạp chí Y Dược Huế. 2025;15(7):131-138. doi:10.34071/jmp.2025.7.17
10. Liberman L, Abramson AF, Squires FB, et al. The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. AJR Am J Roentgenol. 1998;171(1):35-40. doi:10.2214/ajr.171.1.9648759
11. Kim SY, Kim HY, Kim EK, et al. Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS. Ann Surg Oncol. 2015;22(9):2895-901. doi:10.1245/s10434-014-4362-6
12. Grimm LJ, Rahbar H, Abdelmalak M, et al. Ductal Carcinoma in Situ: State-of-the-Art Review. Radiology. 2022;302(2):246-255. doi:10.1148/radiol.211839
13. 1Chesebro AL, Winkler NS, Birdwell RL, et al. Developing Asymmetry at Mammography: Correlation with US and MR Imaging and Histopathologic Findings. Radiology. 2016;279(2):385-94. doi:10.1148/radiol.2015151131
4. Bahl M, Lamb LR, Lehman CD. Pathologic Outcomes of Architectural Distortion on Digital 2D Versus Tomosynthesis Mammography. AJR Am J Roentgenol. 2017;209(5):1162-1167. doi:10.2214/ajr.17.17979
15. Chan HP, Helvie MA, Hadjiiski L, et al. Characterization of Breast Masses in Digital Breast Tomosynthesis and Digital Mammograms: An Observer Performance Study. Acad Radiol. 2017;24(11):1372-1379. doi:10.1016/j.acra.2017.04.016