Dr. G. Saguatti

Breast Unit of Bellaria Hospital, Bologna - Italy

 

Within the framework of a partnership this breast imaging department has had for several years with the company IMS, which supplied us with the digital mammography units we are still using, we have had the opportunity also to equip ourselves with a tomosynthesis instrument, a mammography unit which represents an extraordinary technological leap forward compared to a digital mammography unit when it comes to diagnosing breast diseases.

Tomosynthesis represents a transition from two-dimensional studies to three-dimensional studies.

As is well known, precisely in virtue of the technical features of the instrument, there’s a possibility of studying the breast in successive layers of tissue, with several undoubted advantages.

Fundamentally, in this manner we eliminate, we can say almost completely, the artifacts caused by overlapping, which have always been characteristic of mammography.

We have a decidedly greater possibility of detection in the case of dense breast tissue, and thus of overcoming this enormous historical problem of traditional mammography, represented precisely by high density. We have the possibility of revealing micro calcifications and thus of studying them better. In a nutshell, the advantages that tomosynthesis has and represents compared to a simple digital mammography unit, let’s define it as such, fundamentally consist in an extremely high imaging sensitivity and acquisition of data with high specificity.

It is clear that given these characteristics we can easily guess the extraordinary value that the application of tomosynthesis can have in the field of breast screening.

In this department we perform around 60,000 screening mammography examinations a year; therefore, this is a greatly felt, highly topical subject for us.

The results already tell us that, precisely because of the positive characteristics just described, there is undoubtedly a reduction in recall rates and the possibility of getting a more in-depth assessment of the breast, thus eliminating both false positives and false negatives.

We in fact rely on tomosynthesis for a more detailed study of lesions already detected with a digital mammography unit. We rely on tomosynthesis in some situations also to reveal the presence of a multifocal, even if not bilateral, pathology that is not revealed by a digital mammography unit. We rely on tomosynthesis to assess situations considered suspect on examination with a digital mammography unit, whereas with tomosynthesis we are able to determine the absence of pathologies.

I repeat, these are certainly applications that we see as absolutely extraordinary in their effects, especially in the case of a mass investigative procedure such as screening mammography.