Study of Over 450,000 Women Finds 3D Mammography Detects More Invasive Cancers and Reduces Recall Rates
Researchers found that three-dimensional (3D) mammography (also known as digital breast tomosynthesis) detected significantly more invasive cancers than a traditional mammogram alone and reduced call-backs for additional imaging. Published in JAMA, this is the largest study reported to date—with nearly a half a million women—measuring the effectiveness of the technology, and could potentially lead to a change in the standard of care for breast screening.
“It’s the most exciting improvement to mammography that I have seen in my career, even more important for women than the conversion from film-screen mammography to digital mammography,” said senior author Emily F. Conant, MD, Chief of Breast Imaging the Department of Radiology at the Perelman School of Medicine at the University of Pennsylvania. “3D mammography finds more clinically significant breast cancers earlier, which is the key so that women have more treatment options and ultimately better health outcomes.”
Study Details
In the retrospective study, the researchers looked at 281,187 digital mammography examinations and 173,663 examinations with both tomosynthesis and digital mammography between 2010 and 2012. The data set included women from a wide range of breast cancer screening programs that were both geographically diverse and included both academic and community practices, 13 in total.
Researchers found 41% more invasive cancers when women were screened with tomosynthesis plus digital mammography compared to digital mammography alone. The use of tomosynthesis also reduced the number of women called back for additional testing by 15%.
Promising New Screening Technology
Conventional digital mammography is the most widely used screening modality for breast cancer, but may yield false-positives, which are associated with a higher recall rate.
Tomosynthesis, however, allows for 3D reconstruction of the breast tissue, giving radiologists a clearer view of the overlapping slices of breast tissue. Although it is a relatively new technology, it has shown promise at reducing recall rates in all groups of patients, including younger women and those with dense breast tissue, and better detection rates in smaller studies. In 2011, tomosynthesis was approved by the U.S. Food and Drug Administration to be used in combination with standard digital mammography for breast cancer screening.
According to the authors, 3D mammography is the only method used for breast cancer imaging that has demonstrated this combined benefit. While 3D mammography found more invasive cancers, detection of in situ cancers was similar to a traditional mammography.
“The coming years will be very exciting, as we see further improvements in this innovative technology,” said Dr .Conant. “This new technology will certainly change the way we screen women.”
Sarah M. Friedewald, MD, of Caldwell Breast Center, Advocate Lutheran General Hospital, Park Ridge, Illinois, is the corresponding author for the JAMA article.
The study was funded by grants from the National Cancer Institute and Hologic. For full disclosures of the study authors, visit jama.jamanetwork.com.
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®.
