The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Palpable Breast Masses Discussion of Procedures by Variant Variant 1: Adult female, 40 years of age or older. Palpable breast mass. Initial imaging. Digital Breast Tomosynthesis Diagnostic Diagnostic digital breast tomosynthesis (DBT) should be used for initial imaging evaluation. A small radio-opaque marker is placed on the skin over the palpable finding to identify its location. Several prior studies have shown the diagnostic accuracy of DBT is equivalent to or better than supplemental diagnostic mammographic views in the workup of women with clinical signs and symptoms and in women recalled from screening [11-14]. The added features of planar imaging and thin-section reconstructions allow further assessment of potential false-positive findings. In a recent study, DBT provided similarly accurate diagnostic results as compared with digital mammography (DM) in women with palpable breast masses for detecting breast cancer using either combination DM with DBT (DM/DBT) or DM alone [15]. Several small studies, which specifically included women presenting with clinical symptoms including palpable lumps, demonstrated increased accuracy on combination DM/DBT compared with DM alone [13,16,17]. Additionally, it was demonstrated that DBT may improve lesion detection and characterization with higher conspicuity scores as compared with conventional DM imaging, particularly for cancers presenting as spiculated masses and distortions [17].
Palpable Breast Masses. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Palpable Breast Masses Discussion of Procedures by Variant Variant 1: Adult female, 40 years of age or older. Palpable breast mass. Initial imaging. Digital Breast Tomosynthesis Diagnostic Diagnostic digital breast tomosynthesis (DBT) should be used for initial imaging evaluation. A small radio-opaque marker is placed on the skin over the palpable finding to identify its location. Several prior studies have shown the diagnostic accuracy of DBT is equivalent to or better than supplemental diagnostic mammographic views in the workup of women with clinical signs and symptoms and in women recalled from screening [11-14]. The added features of planar imaging and thin-section reconstructions allow further assessment of potential false-positive findings. In a recent study, DBT provided similarly accurate diagnostic results as compared with digital mammography (DM) in women with palpable breast masses for detecting breast cancer using either combination DM with DBT (DM/DBT) or DM alone [15]. Several small studies, which specifically included women presenting with clinical symptoms including palpable lumps, demonstrated increased accuracy on combination DM/DBT compared with DM alone [13,16,17]. Additionally, it was demonstrated that DBT may improve lesion detection and characterization with higher conspicuity scores as compared with conventional DM imaging, particularly for cancers presenting as spiculated masses and distortions [17].