Posted: Monday, April 3, 2023
Emily F. Conant, MD, of the Hospital of the University of Pennsylvania, Philadelphia, and colleagues aimed to compare the outcomes of digital breast tomosynthesis and digital mammography in routine mammographic screening of women in the United States. In their large study of more than two million screening exams across five large and diverse health-care systems, increased cancer detection combined with fewer false-positive results was significantly improved with digital breast tomosynthesis compared with two-dimensional mammography alone.
“Therefore, women should seek out sites that routinely offer breast cancer screening with digital breast tomosynthesis,” Dr. Conant suggested in a press release from the Radiological Society of North America.
Published in Radiology, this retrospective cohort study included 2,528,063 screening mammograms from 1,100,447 women between the ages of 40 and 79 who underwent either digital mammography or digital breast tomosynthesis between January 2014 and December 2020. The study evaluated the recall rate, cancer detection rate, positive predictive value of recall, biopsy rate, and positive predictive value of biopsy between digital mammography and digital breast tomosynthesis.
The results showed that digital breast tomosynthesis yielded a significantly lower recall rate and higher cancer detection rate, positive predictive value of recall, and biopsy rates compared with digital mammography. The positive predictive value of biopsy was similar between the two cohorts. After the investigators adjusted for age, breast density, site, and index year, the associations remained stable in terms of statistical significance. The findings suggest that women undergoing digital breast tomosynthesis had improved screening mammography outcomes compared with those undergoing digital mammography.
The study contributes to the growing body of evidence that supports the use of digital breast tomosynthesis in mammographic screening, since it results in a reduction of recall rates and an increase in cancer detection rates. The results may inform future screening mammography recommendations and guide clinical practice in breast cancer screening.
Disclosure: For full disclosures of the study authors, visit pubs.rsna.org.