Digital Breast Tomosynthesis for Upgraded BIRADS Scoring towards the True Pathology of Lesions Detected by Contrast-Enhanced Mammography

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Very well designed and well-written research paper. Overall, I believe the manuscript contains some useful research elements and important information in the field. I don't have very many corrections or comments on it. I think the article covers the journal's area well and can contribute positively to the journal. However, I have the following very few comments: Some of the text on Figures 1 and 4 is not quite clear and is too small, so I think it should be improved. In the discussion section from lines 173-184, it sounds like an introduction, so it might be better to move it to the introduction section. The introduction section is also short.

Author Response

May 9, 2024

Dear editor

Thank you for the in-depth review of our original paper entitled, " Digital breast tomosynthesis for upgrade BIRADS scoring towards the true pathology of lesions detected by contrast-enhanced mammography ​"

 

Figures 1 and 4 is not quite clear and is too small,

Were corrected

In the discussion section from lines 173-184, it sounds like an introduction, so it might be better to move it to the introduction section.

Was deleted and introduction was expanded

Lines 42-49, 58-69, 182-183

Reviewer 2 Report

Comments and Suggestions for Authors

Introduction:

-Please add some information from literature of additional lesions seen in CEM, in terms of sensitivity ad spec, since you analyzed a population with biopsy proven cancer and additional lesions.

Materials&Methods:

- Did the readers knew the site of the B5 lesion?

-Line 92-93: please clarify if the lesions were visibile only on CEM or if you did a second-look.

-Line 105-106: not really clear, please rephrase it.

Table1:

I would call post CEM biopsy as additional lesions

Results:

- Since your follow-up is 1 year, you should list it as a limitation

-Line 135-137: were these lesions visible just in CEM?

Discussion:

- Line 178-179, please add a citation (BIRADS CEM lexicon).

Comments on the Quality of English Language

Good quality

Author Response

Dear editor

Thank you for the in-depth review of our original paper entitled, " Digital breast tomosynthesis for upgrade BIRADS scoring towards the true pathology of lesions detected by contrast-enhanced mammography"

Please add some information from literature of additional lesions seen in CEM, in terms of sensitivity ad spec, since you analyzed a population with biopsy proven cancer and additional lesions.

Was added to the introduction lines 55-59

Materials&Methods:

- Did the readers knew the site of the B5 lesion?

Were blinded to al lesion's pathology added to line 89

-Line 92-93: please clarify if the lesions were visibile only on CEM or if you did a second-look.

Evaluation included all modalities as needed, added to line 91-92

-Line 105-106: not really clear, please rephrase it.

Rephrased lines 106-108

Table1:

I would call post CEM biopsy as additional lesions

changed

Results:

- Since your follow-up is 1 year, you should list it as a limitation

Added- line 247-248

-Line 135-137: were these lesions visible just in CEM?

Most were detected by US MRI and DBT , 2 were CEM only, all BIRADS score was 3 and they were followed up , lines 144-147

Discussion:

- Line 178-179, please add a citation (BIRADS CEM lexicon).

Added, now line 199

Reviewer 3 Report

Comments and Suggestions for Authors

The authors explored the added value of DBT in the assessment of lesions detected by CEM. The study is clearly presented and discussed. I have no special remarks.

Comments on the Quality of English Language

Minor editing of English language required

Author Response

May 9, 2024

Dear editor

Thank you for the in-depth review of our original paper entitled, " Digital breast tomosynthesis for upgrade BIRADS scoring towards the true pathology of lesions detected by contrast-enhanced mammography"

Minor editing of English language required

English  corrected