Evaluation Of The Diagnostic Value Of Digital Breast Tomosynthesis And Ultrasonography For Intraductal Papilloma Of The Breast

Objective: To retrospectively compare the detection rate and diagnostic accuracy of digital breast tomosynthesis(DBT),digital mammography(DM),and ultrasonography(US)in intraductal papilloma(IDP)of the breast.Materials and Methods: The data of 790 cases of breast intraductal papilloma confirmed by surgery and pathology from December 2012 to December 2017 in our hospital were retrospectively analyzed.We excluded 207 intraductal papilloma with atypical hyperplasia lesions and 83 intraductal papilloma with ductal carcinoma in situ lesions,and included 696 intraductal papilloma lesions in this study.There were 339non-mass-like intraductal papilloma lesions and 357 mass-like intraductal papilloma lesions detected by US.The imaging findings were evaluated according to the Breast Imaging Reporting and Data System(BI-RADS)of the American College of Radiology(ACR): 1.To analyse the imaging finding types of non-mass-like and mass-like intraductal papilloma of the breast by digital breast tomosynthesis,digital mammography and ultrasonography and the imaging findings of mass-like intraductal papilloma of the breast;2.To compare the differences in the detection rate and diagnostic accuracy among the three techniques in all intraductal papilloma;3.To compare the differences in the detection rate and diagnostic accuracy among the three techniques in non-mass-like intraductal papilloma lesions and mass-like intraductal papilloma lesions.The differences were statistically significant(P<0.05).Results: 1.On DBT and DM,seven types of non-mass-like intraductal papilloma lesions were detected.Most non-mass-like lesions presented as asymmetric densification and asymmetric densification with structure distortion;two types of mass-like intraductal papilloma lesions were detected.Most mass-like lesions presented as round and oval,circumscribed and isodensity;On US,six types of non-mass-like intraductal papilloma lesions were detected.Most non-mass-like lesions presented as solid mass with in dilatation duct and simple duct dilatation;three types of mass-like intraductal papilloma lesions were detected.Most mass-like lesions presented as round and oval,circumscribed,paralleled the skin,posterior acoustic normal,blood flow signal of type I,hypoechoic.2.In the all intraductal papilloma,DBT compared with DM,US compared with DBT,and US compared with DM on the detection rate(60.6% vs 44.7%,99.0% vs 60.6%,99.0%vs 44.7%)and diagnostic accuracy(51.3% vs 39.4%,80.2% vs 51.3%,80.2% vs 39.4%)of intraductal papilloma were all higher,the differences were statistically significant(P<0.05).3.In the non-mass-like intraductal papilloma,DBT compared with DM,US compared with DBT,and US compared with DM on the detection rate(55.5% vs 40.4%,97.9% vs 55.5%,97.9% vs 40.4%)and diagnostic accuracy(47.5% vs 37.5%,83.2% vs47.5%,83.2% vs 37.5%)of non-mass-like intraductal papilloma were all higher,the differences were statistically significant(P<0.05).In the mass-like intraductal papilloma,DBT compared with DM,US compared with DBT,and US compared with DM on the detection rate(65.5% vs 48.7%,100.0% vs 65.5%,100.0% vs 48.7%)and diagnostic accuracy(54.9% vs 41.2%,77.3% vs 54.9%,77.3% vs 41.2%)of mass-like intraductal papilloma were all higher,the differences were statistically significant(P<0.05).Conclusion: DBT and US gave better the detection rate and diagnostic accuracy for intraductal papilloma compared with DM,the detection rate and diagnostic accuracy for intraductal papilloma of US slightly higher than that of DBT.So DBT has a certain application prospect as a new digital mammography technique.