الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most frequently diagnosed cause of death from cancer in women worldwide. Women with dense breast are doubly disadvantaged as they are both at higher risk of developing breast cancer and at greater risk that cancer will not be detected because of masking of the radiological signs of cancer by increased density.
It has been demonstrated that diagnosis and detection affect treatment decisions and outcome. Mammography remains the gold standard for evaluation of breast. However, limitations for mammography do exist, owing to the fact that it represents a two dimensional image of the breast.
Many, relatively new advances have been implemented in order to improve sensitivity and specificity of breast imaging, including along with many others DBT.
This study aimed to display the added value of DBT to the BI-RADS classification.
Twenty five patients with different age group ranging (40-75) years old (mean age 52 years) with clinical signs and symptoms of breast disease (e.g. Palpable breast lumps, or mastalgia) 22 patients of them came f or diagnostic workup and 3 came for follow up after benign lumpectomy.
They underwent full history ,full physical examination of both breast in upright and lying down positions.
All patients underwent two-view (craniocaudal and MLO) full field DM machine with 3D-DBT on (Senographe Essential GE healthcare), and complementary ultrasound using 10 MHz linear probe (Toshiba Aplio 500). Each patient was assigned an independent BIRADS score for FFDM, and DBT.
The final diagnosis was confirmed by histopathology, US as well as follow up imaging. Nine (36%) patients demonstrate benign pathology and malignant lesions in 16 (64%) patients.
On mammography; 2/25 (16%) patients were assigned BIRADS 2, 7/25 (28%) were assigned as BIRADS 3, while 8/25 (26.66%) patients were assigned as BIRADS 4a, 3/25 (12%) were assigned as BIRADS 4b, and 3/25 (12%) were assigned as BIRADS 4c. So after revising the pathology results and close follow up, 12 patients were true positives, 2 patients were false positive 4 patients were false negatives and 7 patients were true negatives. Therefor mammography had a sensitivity of 75% a specificity of 77.78% a positive predictive value of 85.71%, a negative predictive value of 63.64%, and diagnostic accuracy of 76.0%.
On digital breast tomosynthesis; 1/25 (4%) patients were assigned BIRADS 1 for 3/25 (12%)were assigned as BIRADS 2, 5/25 (20%) were assigned as BIRADS 3 ,while 5/25 (20%) patients were assigned as BIRADS 4a. 1/25(4%) was assigned as BIRADS 4b, 1/25(4%) was assigned as BIRADS 4c, 9/25(36%) were assigned as BIRADS 5.So after revising the pathology results and close follow up 15 patient were true positives, 1 patient was false positive, 1 patient was false negatives and 8 patients were true negatives. So, digital breast tomosynthesis had a sensitivity of 93.75 % a specificity of 88.89% a positive predictive value of 93.75 %, a negative predictive value of 88.89% and diagnostic accuracy of 92%.