Digital Breast Tomosynthesis (DBT)

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Digital Breast Tomosynthesis (DBT)

Digital Breast Tomosynthesis

Traditionally, two-dimensional mammography is used to view breast tissue in order to image and diagnose. 

Screening mammography entails the performing of a single two-dimensional image from top to bottom, and a corresponding image side to side of the corresponding breast, all while the unit remains still.

A major limitation of this technique is the possible overlap of breast tissue, specifically glandular breast tissue that is denser. Overlapping tissue can obscure an area of interest and possibly lead to a false-negative finding. In addition, the overlap of normal structures in the breast can create a pseudo lesion. This gives the appearance of a lesion, but is not, thus giving a false positive reading. In the past, the aforementioned was overcome by the performing of additional diagnostic views or examinations in the form of ultrasounds.

Digital breast tomosynthesis (DBT) is a new imaging technology that addresses the aforementioned caused by overlapping structures. Thus, allowing one to separate overlying structures from the other without performing additional imaging. In doing so, the reporting radiologist is able to more clearly identify the lesion with reference to location, size, shape and structural involvement.


As reported in the recent research studies, DBT is in essence emerging as the new standard of breast imaging based on both screening and diagnostic outcomes.

How does Tomosynthesis work?

The arm of the mammography unit will move in an arc, while performing a series of low-dose exposures.
Next, the computer uses complex algorithms to reconstruct images of 1-mm thickness through the breast. A two-dimensional image is then also reconstructed from the volumetric dataset on a workstation.
In a nutshell, one is able to view the whole breast in slices similar to a sliced loaf of bread.

This technique has shown improved sensitivity and specificity compared with digital mammography. DBT allows for improved lesion detection, characterization and localization. As a result, DBT has led to improvements in patient result outcomes and higher efficiency, as DBT detects more cancers and requires less additional investigation images.

What about the risk of radiation?

Glandular breast tissue is sensitive to radiation, and has a higher risk in developing breast cancer. As a result, it is of extreme importance to limit the radiation dose to breasts.
At Dr de Villiers and Partners, we care about your breasts and so does Siemens, hence their motto:

Every woman has the right to the right dose.

Limiting radiation dose to our patients was one of the deciding factors when deciding on a new breast unit for our department. Our Siemens Mammomat Inspiration Prime has a 30% reduction in dose without compromising image quality.