Enhancing diagnostic precision in breast cancer detection: a Digital Breast Tomosynthesis workshop approach for clinicians in the Southeast Asian population

Background: This study investigated the impact of Digital Breast Tomosynthesis (DBT) training workshops on doctors' performance in simultaneous-double-reader scenarios. Methods: Ten pairs of Vietnamese readers, including radiologists, registrars, and breast physicians, participated in the workshop, which featured lectures and breast image reading sessions provided by Australian experts. The first session included a test set of 30 screening full-field digital mammograms (FFDM) (10 cancers and 20 normal cases) with DBT images provided during the answer review stage. The second session with 35 cases (15 cancer) and session 3 with 30 cases (11 cancer) consisted of screening FFDM mammograms, DBT slices, and synthesized images. Participants used the BREAST-VIETRAD platform to view breast images and detect cancer lesions using the RANZCR-BIRADS scale. The study assessed performance disparities between the first and second DBT sets using the Wilcoxon Signed Rank test and explored the correlation between score changes and reader experience. Results: There were significant improvements in the readers' sensitivity (0.553 vs. 0.91; p = 0.005) and lesion sensitivity (0.419 vs. 0.709; p = 0.005) from the first to the second DBT set, matching the sensitivity seen in FFDM sets. This improvement was consistent across both low and high breast density cases. Notable enhancements in lesion sensitivity were also observed for detecting masses (0.340 vs. 0.633; p = 0.011), calcifications, and architectural distortions (0.450 vs. 0.933; p = 0.011). The probability of score improvement (ROC AUC and JAFROC FOM) in DBT of pairs of readers with both less than 3 years of experience in reading mammograms is five times greater than those with over 5 years of experience. Conclusions: Training sessions with simultaneous-double readers significantly improved Vietnamese clinicians' breast cancer detection capabilities, highlighting the importance of tailored educational programs to enhance diagnostic accuracy in regions lacking formal screening initiatives.