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Digital Breast Tomosynthesis (DBT)

Three-dimensional mammographic technique creating thin section breast images that improves cancer detection and reduces recall rate compared to 2D mammography.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is Digital Breast Tomosynthesis (DBT)?

Digital breast tomosynthesis (DBT) acquires multiple low-dose 2D projections (typically 9-25) over a limited arc (15-50 degrees) and reconstructs thin (1 mm) tomographic slices through the breast. This pseudo-3D imaging reduces tissue overlap which is the primary cause of false-positive findings and missed cancers in 2D digital mammography.

Synthesized 2D images (S2D) generated from DBT projections eliminate the need for separate 2D acquisition, reducing radiation dose by approximately 40% while maintaining diagnostic accuracy. Total dose for combo DBT+2D is similar to film-screen mammography (3-4 mGy/breast). Modern systems integrate DBT with contrast-enhanced mammography (CEM) for difficult cases.

Multiple large trials (STORM, OTST, TOMMY, TMIST) demonstrate consistent benefit in dense breast tissue: 27-40% increase in invasive cancer detection, 15-30% reduction in recall rates, particularly in dense and heterogeneous breasts. DBT is now standard of care in many institutions for screening and diagnostic mammography. Reading time is longer (1.5-2x), and digital archiving requires substantially more storage. Computer-aided detection (CAD) and AI-based DBT analysis reduce reading time and improve sensitivity.

Symptoms

Test, not a disease — clinical indications:
Routine breast cancer screening (especially dense breasts)
Diagnostic evaluation of palpable abnormality
Workup of mammographic finding (asymmetry, distortion)
Follow-up of breast cancer survivors
Pre-biopsy localization of suspicious finding
Evaluation of post-surgical changes
High-risk patient surveillance

Risk Factors

Patient factors affecting examination:
Inability to remain still during compression (4-6 seconds per view)
Recent breast surgery or biopsy (timing considerations)
Breast implants (modified protocol needed)
Pregnancy or recent lactation (relative)
Pacemaker or implanted devices (technical considerations)
Very large or very small breast size (technical limits)
Severe pain limiting compression

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Annual screening for women age 40-74 (per guidelines)
  • Earlier or more frequent screening for high-risk women
  • Palpable breast lump or focal pain
  • Nipple discharge or skin changes
  • Family history with BRCA mutation
  • Prior atypical breast biopsy or LCIS
  • Personal history of breast cancer
  • Dense breast tissue requiring supplementary screening

Treatment Methods

01
Standard mammographic compression positioning
02
DBT acquisition with low-dose projections
03
Synthesized 2D image generation (S2D)
04
Optional combo with full 2D digital mammography
05
Reconstruction of 1mm thin slices
06
Radiologist review with multiplanar reformatting
07
BI-RADS reporting and recall recommendations
08
Targeted ultrasound or MRI for complementary assessment

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.