Mammography and Digital Breast Tomosynthesis: Technique

The introduction of mammography as a radiographic imaging modality optimized for breast imaging revolutionized breast cancer care. Throughout the decades, conventional, screen-film-based mammography has given way to digital mammography, resulting in many benefits, including a streamlined workflow and improved performance in certain subgroups of patients. More importantly, the introduction of digital technology in mammographic imaging resulted in the development of even more advanced technologies, such as digital breast tomosynthesis. Tomosynthesis, with its ability to result in pseudo-tomographic imaging of the breast with a system that has the same footprint and workflow as mammography, has had an important impact in the breast imaging clinic. In this chapter, the basic concepts of X-ray-based breast imaging, common for both mammography and tomosynthesis, are reviewed. The major components of these imaging systems are described, and the resulting and potential clinical and screening performance of these modalities is discussed. Finally, considering their widespread use in asymptomatic women during screening, the dosimetry aspects of X-ray-based breast imaging are explained.