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Utility of tomosynthesis in decreasing skin calcification workup rate

Anna Holbrook,Brianna Vey,Yoon Jin Kim,Yuan Liu,Mary Newell.

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Aim: Tomosynthesis permits some skin calcifications to be identified as such without diagnostic workup. We aim to quantify the reduction in skin calcification workups at our institution after the advent of tomosynthesis.

Methods: This study was approved by the Institutional Review Board with waiver of informed consent. We searched the medical record from 3/1/2011 to 3/31/2017 for all cases of screening mammography with the terms “skin” or “dermal” included in the report. We excluded all cases that did not include a recommendation for skin/dermal calcification workup and/or tangential views. Of the included cases, note was made of whether the screening examination was done without or with tomosynthesis. We calculated the percentage of cases recalled for skin calcification workup that were done without and with tomosynthesis. We then compared the percentages using chi-squared to evaluate for significance.

Results: 40 cases met the inclusion criteria. 24 cases (60%) were done without tomosynthesis, and 16 (40%) were done with tomosynthesis. There were 132,789 total screening mammograms done, 65,299 (49.2%) without tomosynthesis and 67,490 (50.8%) with tomosynthesis. The percentage of all cases recalled for skin calcification workup done without tomosynthesis was 0.037%, and done with tomosynthesis was 0.024% (chi-square statistic 8587744.4875, p < .00001).

Conclusions: We found that since the addition of tomosynthesis to our screening protocol, the recall rate for skin calcification workup has decreased by 35%. However, tomosynthesis did not entirely eliminate the need for skin calcification workup.

Key words: skin calcifications, dermal calcifications, tomosynthesis, DBT

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