{"doi":"10.1016/j.ejrad.2022.110361","title":"A comparative efficacy study of diagnostic digital breast tomosynthesis and digital mammography in BI-RADS 4 breast cancer diagnosis","abstract":"PURPOSE: Probability of malignancy for BI-RADS 4-designated breast lesions ranges from 2% to 95%, contributing to high false-positive biopsy rates. We compare clinical performance of digital breast tomosynthesis (DBT) versus digital mammography (2D) among our BI-RADS 4 population without prior history of breast cancer. METHODS: We extracted retrospective data i.e., clinical, mammogram reports, and biopsy data, from electronic medical records across Houston Methodist's nine hospitals for patients who underwent diagnostic examinations using both modalities (02/01/2015 - 09/30/2020). 2D and DBT cohorts were not intra-individual matched, and there was no direct mammogram evaluation. Using Student's t test, Fisher's exact test, and Chi-squared test, we evaluated the data to determine statistical significance of differences between modalities in BI-RADS 4 cases. We calculated adjusted odds-ratio between modalities for cancer detection rate (CDR) and biopsy-derived positive predictive value (PPV3). RESULTS: There were 6,356 encounters (6,020 patients) in 2D and 5,896 encounters (5,637 patients) in DBT assessed as BI-RADS 4. Using Fisher's exact test, DBT mammography cases were significantly assessed as BI-RADS 4 5.66% more often than those undergoing 2D mammography, P = 0.0046 (1.0566 95% CI: 1.0169-1.0977). The CDRs were 112.65 (2D) and 120.76 (DBT), adjusted odds-ratio: 1.04 (0.93, 1.16)), P = 0.5029, while PPV3 were 14.41% (2D) and 15.99% (DBT), adjusted odds-ratio: 1.09 (0.97, 1.22), P = 0.1483; both logistic regression-adjusted for all other factors. CONCLUSION: DBT did not achieve better performance and sensitivity in assigning BI-RADS 4 cases compared with 2D, showed no significant advantage in CDR and PPV3, and does not reduce false-positive biopsies among BI-RADS 4-assessed patients.","journal":"European Journal of Radiology","year":2022,"id":283494,"datarank":0.4194581602142364,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"self_citation_contribution":0.29188652235829704,"citation_network_contribution":0.12757163785593933,"self_endowment_contribution":0.29188652235829704,"citer_contribution":0.12757163785593933,"corpus_percentile":55.76699930378278,"corpus_rank":5719,"citation_count":6,"citer_count":5,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.6004,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":956932,"name":"Mamta Puppala","orcid":"0000-0001-6763-5885","position":1,"is_corresponding":false},{"id":379429,"name":"Lin Wang","orcid":"0000-0002-6449-4930","position":2,"is_corresponding":false},{"id":276042,"name":"Jenny C. Chang","orcid":"0000-0002-0890-9302","position":3,"is_corresponding":false},{"id":97864,"name":"Stephen T.C. Wong","orcid":"0000-0001-9188-6502","position":4,"is_corresponding":false},{"id":655148,"name":"Chika F. Ezeana","orcid":"0000-0001-8305-8272","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-19T00:29:28.452697Z","pmid":"35617870","pmcid":"PMC10347302","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}