Digital mammography -guided versus digital breast Tomosynthesis- guided biopsy: A comparative study of sampling suspicious breast calcifications
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BACKGROUND: While digital mammography (DM)-guided stereotactic biopsy has traditionally been used to sample suspicious calcifications, digital breast tomosynthesis (DBT)-guided biopsy is gaining preference due to its advantages. However, studies directly comparing the two techniques for sampling calcifications remain limited. PURPOSE: This study aims to compare the performance of DBT- versus DM-guided biopsies for suspicious calcifications, focusing on procedure time and radiation dose to inform best practices in biopsy technique. METHODS: This IRB-approved retrospective study under reference # 21-01023100 reviewed 2200 biopsies and records of 2126 patients who underwent stereotactic biopsies for suspicious calcifications at a single institution between October 1, 2020 to August 1, 2023. Data collected included procedure time, radiation dose, number of imaging exposures, and pathology results. Comparative analysis of the two techniques was conducted using a two-sample t test for continuous variables and a chi-square test for categorical variables comparing patient characteristics and key outcomes, while adjusting for radiologist influence. RESULTS: From 2020 to 2023, the number of stereotactic biopsies steadily increased, with 76% (1,335) performed using DM guidance and 24% (421) using DBT guidance, with DBT showing advantages in shorter procedure times (14 ± 8 min vs. 15 ± 8 min, p < 0.001), fewer exposures (5.7 ± 2.9 vs. 8.6 ± 3.6, p < 0.001), and lower radiation doses (13 ± 7 mGy vs. 15 ± 9 mGy, 0.005), all statistically significant. However, there were no significant differences in malignancy rates between DM and DBT groups (16% malignant in both, p > 0.05). CONCLUSION: DBT-guided biopsies of suspicious calcifications offer shorter procedure times and reduced radiation exposure compared to DM-guided biopsy, without a significant difference in malignancy rates.