Background and purpose: Breast cancer is the most common malignancy in women. The new technology of mammography is helpful in breast cancer diagnosis. This study aimed to compare the efficacy of digital breast tomosynthesis (DBT) with conventional imaging methods in the diagnosis of benign and malignant breast lesions. Methods: During the period from Mar. 2015 to Dec. 2015

227 patients with suspected lesions (by palpation or sonography) underwent further imaging exam in our hospital. The sonography

full-field digital mammography (FFDM)

DBT and breast MRI were performed on all the patients. A double-blind assessment was carried out according to BI-RADS (version 2013) by experienced radiologists. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of all methods

referring to the pathological data as the golden standard; the difference in the efficiency of DBT from the other methods was determined by Z-test. Results: Thirty patients were excluded for the unsatisfactory images

and 205 lesions (132 malignant and 73 benign lesions) were detected in the remaining 197 patients. Area under the curve (AUC) of sonography

FFDM

DBT

DBT+FFDM and MRI based on the BI-RADS were 0.830 8

0.859 2

0.916 7

0.919 8

and 0.935 4

respectively. The AUC of DBT was significantly higher than those of sonography (Z=7.36

P=0.006 7) and FFDM (Z=4.89

P=0.027 1)

while there was no significantly difference between DBT and MRI (Z=0.02

P=0.900 2) or FFDM+DBT (Z=0.69

P=0.404 8). Conclusion: DBT could significantly improve the diagnostic performance for breast lesions compared with sonography and FFDM

providing a comparable efficiency to MRI. As a new mammography technology

DBT has good clinical application prospect.