Digital Breast Tomosynthesis Shows Sustained Effectiveness in Breast Cancer Screening
In a single-center retrospective study reported in JAMA Oncology, McDonald et al found that adding digital breast tomosynthesis to digital mammography reduced recall rates, increased cancer detection, and was associated with a numeric reduction in interval cancers.
Study Details
The analysis included all patients presenting for screening mammography in an urban academic breast center (Perelman School of Medicine, University of Pennsylvania) during 4 consecutive years (2010–2014); screening was with digital mammography in year 0 (DM0) and with digital mammography and digital breast tomosynthesis in years 1 to 3 (DBT1–DBT3). A total of 44,468 screenings were performed for 23,958 women, with 10,728 women screened in year DM0, 11,007 in DBT1, 11,157 in DBT2, and 11,576 in DBT3.
Recall and Detection Rates
Recall rates per 1,000 women screened were 88 for DBT1 (odds ratio [OR] = 0.83, P < .001), 90 women for DBT2 (OR = 0.85, P < .001), and 92 for DBT3 (OR = 0.87, P = .003) compared with 104 for DM0. Cancer cases among recalled patients were 4.4% in DM0 compared with 6.2% in DBT1 (P = .06), 6.5% in DBT2 (P = .03), and 6.7% in DBT3 (P = .02). Among women undergoing one, two, and three digital breast tomosynthesis screenings, recall rates per 1,000 women screened were 130, 78, and 59 (P < .001). Interval cancer rates per 1,000 women screened were 0.7 for digital mammography and 0.5 for DBT1 (P = .60).
The investigators concluded: “Digital breast tomosynthesis screening outcomes are sustainable, with significant recall reduction, increasing cancer cases per recalled patients, and a decline in interval cancers.”
The National Cancer Institute supported this study.
Emily F. Conant, MD, of Perelman School of Medicine, is the corresponding author of the JAMA Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
