[Comparison of the diagnostic efficiency in breast malignancy between cone beam breast CT and mammography in dense...

Objective: To compare the diagnostic efficiency of lesion in dense breast between cone beam breast computer tomography (CBBCT) and mammography. Methods: From May 2012 to August 2014, 160 patients with 165 breasts who underwent mammography and CBBCT examinations were included in this study. The diagnostic results of CBBCT and mammography were reviewed and compared with pathological results. Results: In the 165 breast, 24 were dense breasts and 141 were dense breasts. The diagnostic results were similar in 109 lesions, but different in 56 lesions. According to the analysis of the 165 breasts using receiver operation characteristics (ROC) curve, the area under the ROC curves (AUC) of CBBCT and mammography were 0.923 (95%CI: 0.878-0.967, P<0.05) and 0.959 (95%CI: 0.926-0.992, P<0.05), respectively. With Breast Imaging-Reporting and Data System (BI-RADS) 4b as the critical value, the sensitivity and specificity were 70.0% and 98.7% using mammography, and 83.3% and 97.3% using CBBCT, respectively. The AUC of CBBCT and mammography of the 141 dense breasts was 0.919(95%CI: 0.868-0.969, P<0.05) and 0.973(95%CI: 0.947-0.999, P<0.05), respectively. With BI-RADS 4b as the critical value, the sensitivity and specificity were 69.0% and 98.6% by mammography, and 83.1% and 98.6% by CBBCT, respectively. Conclusions: CBBCT showed higher sensitivity and specificity in the diagnosis of breast malignant tumors compared to mammography. It is expected to be applied to breast cancer detection in the future, especially in dense breast.