To assess the value of CBBCT in breast cancer detection and diagnosis with comparison to digital mammography（DM）.
28 patients with pathologically confirmed breast cancer were studied and were enrolled under an IRB approved study protocol. CBBCT exam was performed after DM. 6 patients had contrast-enhanced CBBCT (CE-CBBCT). The CBBCT and FFDM images were reviewed separately. Patient demographics, breast density, lesion type, size on CBBCT and DM were recorded. Vessels on CBBCT and CE-CBBCT were evaluated and the CT number were recorded. The accuracy of CBBCT and DM in breast cancer diagnosis and the detection of masses (ill-defined, lobulated and spiculated), and calcifications were compared with Chi-square test.
No difference in detecting breast cancer between CBBCT and DM (p>0.05). Of the 28 patients, 26 had masses or asymmetrical density and 11 had malignant calcifications. CBBCT showed 23 with masses and 3 with focal asymmetrical density, whereas DM showed 16 with masses and 10 with focal asymmetrical density. 11 malignant calcification cases were both detected on CBBCT and DM. The difference between CBBCT and DM in the detection of lobulated masses and calcifications had no significance (p>0.05). There were differences in detecting ill-defined and spiculated masses on two modalities (p<0.05). 23 cases with increased vessels around the lesion were observed on CBBCT. For the 6 patients who had CE-CBBCT, all masses had heterogeneous enhancement. Two cases were detected with new multifocal lesions with CE-CBBCT, not found in CBBCT or DM .
Conclusions: CBBCT can provide high quality 3D images without compression of the breast. It is a promising technique to visualize various manifestations of breast cancer and provide accurate localization of the lesions. Vessels can be clearly displayed in the 3D space. CE-CBBCT could be used to further help with breast cancer diagnosis and evaluating extent of disease.