Breast Cancer Coverage from Every Angle

Digital Breast Tomosynthesis Versus Digital Mammography: Long-Term Outcomes

By: Melissa Steele-Ogus
Posted: Friday, March 20, 2020

According to a retrospective study published in the journal Radiology, digital breast tomosynthesis was reported to be superior to digital mammography in terms of improved cancer detection rates and reduced recall rates. Emily Conant, MD, of the Perelman School of Medicine at the University of Pennsylvania, and colleagues, evaluated more than 56,000 breast tomosynthesis exams and 10,500 digital mammography exams over a 5-year period.

“We showed that the improved performance with [digital breast tomosynthesis] was maintained over multiple years,” Dr. Conant said in a Radiological Society of North America press release. “This is the longest follow-up with cancer registry matching that has been published thus far.”

The retrospective analysis involved multiple rounds of screening, consisting of 1 year of digital mammography and 5 years of digital tomosynthesis. A total of 29,310 women participated in the study and received 67,350 examinations.

Cancer detection rates were 6 per 1,000 with tomosynthesis, compared with 5.1 per 1,000 with mammography alone. Screening recall rates were 8% with tomosynthesis, compared with 10.4% with mammography alone (P < .001). There were no significant differences in false-negative or cancer detection rates between the two populations. Biopsy recommendation rates, positive predictive value of recall, and specificity were significantly better on the patient level with digital breast tomosynthesis than with digital mammography screening (P ≤ .001) in the adjusted analysis. Finally, more cancers screened via tomosynthesis were categorized as invasive (70.0% vs. 68.5%) and linked to a poorer prognosis (32.6% vs. 25.0%) than those detected via digital mammography.

“Our results show that we can improve our screening outcomes for younger women with [digital breast tomosynthesis] by finding clinically important cancers earlier with fewer false-positives,” commented Dr. Conant.

Disclosure: For full disclosures of the study authors, visit

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