Academic radiology · 2026
Comparison of Digital Breast Tomosynthesis-Guided Biopsy versus Ultrasound-Guided Biopsy of Non-Calcified Breast Lesions.
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Baikpour Masoud, Lamb Leslie R, Magara Emmanuel, Bahl Manisha, Lehman Constance D, Chou Shinn-Huey S
Аннотация
RATIONALE AND OBJECTIVE: To compare the imaging characteristics and biopsy outcomes of noncalcified mammographic findings that underwent digital breast tomosynthesis-guided biopsy (DBT-BX) versus ultrasound-guided biopsy (US-BX).
MATERIALS AND METHODS: In this HIPAA-compliant retrospective study, consecutive patients who underwent DBT-BX or US-BX between 4/1/2016 and 3/31/2018, were identified through the Radiology Information System. Eligible patients had a mammographically visible, noncalcified lesion and targeted US evaluation. Patient demographics, breast density, lesion type, BI-RADS category, clip placement accuracy, and pathology results were recorded. Statistical comparisons between groups were performed using the Mann-Whitney U test for continuous variables and Pearson's chi-squared test for categorical variables.
RESULTS: The DBT-BX group included 215 patients (224 biopsies; mean age, 58.7±12.2 years), and the US-BX group included 907 patients (949 biopsies; mean age, 57.4±14.5 years). DBT-BX targeted asymmetries (45.5%), architectural distortions (33.0%), and masses (21.4%), while US-BX targeted primarily sonographic correlates of masses (57.1%) and asymmetries (39.7%). DBT-BX was more frequent in non-dense breasts (65.6% vs 50.2%; p<0.001) and demonstrated higher clip displacement rates (10.3% vs 1.6%; p < 0.001). The positive predictive value for malignancy (PPV3) was significantly lower for DBT-BX (33.5%) compared with US-BX (47.7%; p<0.001), particularly for asymmetries (28.4% vs 49.9%; p<0.001) and architectural distortions (31.1% vs 73.3%; p=0.001).
CONCLUSION: US-BX of noncalcified breast lesions demonstrated higher PPV3 and lower clip displacement rates compared with DBT-BX. DBT-BX of suspicious asymmetries and distortions, however, maintained clinically relevant PPV3 and remains appropriate when no definite US correlate is present.
MATERIALS AND METHODS: In this HIPAA-compliant retrospective study, consecutive patients who underwent DBT-BX or US-BX between 4/1/2016 and 3/31/2018, were identified through the Radiology Information System. Eligible patients had a mammographically visible, noncalcified lesion and targeted US evaluation. Patient demographics, breast density, lesion type, BI-RADS category, clip placement accuracy, and pathology results were recorded. Statistical comparisons between groups were performed using the Mann-Whitney U test for continuous variables and Pearson's chi-squared test for categorical variables.
RESULTS: The DBT-BX group included 215 patients (224 biopsies; mean age, 58.7±12.2 years), and the US-BX group included 907 patients (949 biopsies; mean age, 57.4±14.5 years). DBT-BX targeted asymmetries (45.5%), architectural distortions (33.0%), and masses (21.4%), while US-BX targeted primarily sonographic correlates of masses (57.1%) and asymmetries (39.7%). DBT-BX was more frequent in non-dense breasts (65.6% vs 50.2%; p<0.001) and demonstrated higher clip displacement rates (10.3% vs 1.6%; p < 0.001). The positive predictive value for malignancy (PPV3) was significantly lower for DBT-BX (33.5%) compared with US-BX (47.7%; p<0.001), particularly for asymmetries (28.4% vs 49.9%; p<0.001) and architectural distortions (31.1% vs 73.3%; p=0.001).
CONCLUSION: US-BX of noncalcified breast lesions demonstrated higher PPV3 and lower clip displacement rates compared with DBT-BX. DBT-BX of suspicious asymmetries and distortions, however, maintained clinically relevant PPV3 and remains appropriate when no definite US correlate is present.