COMPARISON OF DIAGNOSTIC ACCURACY OF MAMMOGRAPHY VERSUS TOMOSYNTHESIS IN DIAGNOSIS OF BREAST LESIONS KEEPING HISTOPATHOLOGY AS GOLD STANDARD

Abstract

OBJECTIVES: to compare the diagnostic accuracy of digital mammography (DM) and digital breast tomosynthesis (DBT) in detecting breast lesions, using histopathology as the gold standard. STUDY SETTINGS AND DURATION: This cross-sectional study was conducted over six months at the Department of Diagnostic Radiology, CMH Lahore from July 2024 to December METHODOLOGY:A total of 123 patients with palpable breast lumps or  a family history of breast cancer were enrolled through non-probability consecutive sampling. Each patient underwent dm and dbt, followed by biopsy for histopathological confirmation. Imaging findings were categorized using bi-rads classification. sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. RESULTS: DBT demonstrated superior diagnostic performance compared to dm, with sensitivity of 85.25% vs. 70.49%, specificity of 80.65% vs. 66.13%, ppv of 81.25% vs. 67.19%, and npv of 84.75% vs. 69.49%. The overall accuracy was higher for dbt (82.93%) than dm (68.29%). CONCLUSION: DBT outperforms dm in detecting breast lesions with improved accuracy, particularly in dense breast tissue. While some studies report no significant difference, our findings support dbt as a preferred imaging modality. Future research should focus on multi-center validation, long-term outcomes, and ai integration to optimize breast cancer detection.