DBT experience: interview with Dr. Philippe Sebag, breast specialist in Nice
Dr. Philippe Sebag, a breast specialist for 20 years, has been using our Giotto Tomo mammography device for 1 year in Nice , France
With your hindsight and experience in diagnostic mammography and breast vacuum biopsy, what is your opinion of Tomosynthesis in daily use?
Mammography coupled with tomosynthesis permits a significant improvement in diagnoses, involving the precise 3D localization of lesions.
It is a comforting work tool that, for example, easily eliminates the tissue superimposition effect.
With Cine mode (i.e. in which slices are displayed automatically through image scrolling), it is possible to obtain an immediate overview of the breast.
What is the utility of performing tomosynthesis?
The procedure is effective in detecting minor structural distortions and in confirming asymmetrical density. The stereotactic biopsy procedures to which this can give rise benefit from the precision of localization afforded by tomosynthesis (instead of a cross-section, a 3D image of the lesion is obtained).
What, in your opinion, is the ideal angle of incidence in tomosynthesis imaging?
Personally speaking, although an oblique angle of incidence makes it possible to obtain a maximum amount of fibro-glandular tissue and allow imaging of the breast including the pectoral muscle, in most cases, I initially employ a craniocaudal angle; but with some exceptions (small breasts and breasts having undergone operations, for instance) and in order to minimize the dose, the craniocaudal angle helps to situate the lesion both along the transverse (external, median, internal) and longitudinally (upper, median, lower). Secondarily, and where necessary, a second angle of incidence solely on the targeted breast may then be envisaged.