Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography

Friedewald, Sarah M.; Rafferty, Elizabeth A.; Rose, Stephen L.; Durand, Melissa A.; Plecha, Donna; Greenberg, Julianne S.; Hayes, Mary K.; Copit, Debra S.; Carlson, Kara L.; Cink, Thomas M.; Barke, Lora D.; Greer, Linda N.; Miller, Dave P.; Conant, Emily F.

doi:10.1001/jama.2014.6095

Cited by 732 publications

(399 citation statements)

References 18 publications

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“…As expected, the greatest gains in sensitivity were observed for younger women and those with heterogeneously dense breasts [36,37], but interestingly, there was no significant increase in cancer detection in those with extremely dense breasts [37]. DBT is currently being used in Australia as a diagnostic tool, but there is increasing evidence to suggest that it may be beneficial as a screening tool [33][34][35][36]. However, it is common practice to use DBT in conjunction with, rather than instead of, digital mammography, which results in a total examination dose approximately 2-3 times that of digital mammography alone.…”

Section: Advances In Technologymentioning

confidence: 54%

“…The main advantage of DBT is that it significantly reduces the effects of superimposition, thereby enabling visualisation of lesions that would be masked by over-or under-lying tissue and distinguishing real lesions from those mimicked by superimposition of normal structures [29]. A number of studies on large screening populations showed an increase in overall cancer detection rate and a reduction in recall rate when using DBT in addition to 2D digital mammography, compared to using 2D digital mammography alone [33][34][35][36]. As expected, the greatest gains in sensitivity were observed for younger women and those with heterogeneously dense breasts [36,37], but interestingly, there was no significant increase in cancer detection in those with extremely dense breasts [37].…”

Section: Advances In Technologymentioning

confidence: 99%

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How many physicists does it take to test a mammography unit?

Diffey¹

2017

Australas Phys Eng Sci Med

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Mammography is defined as the X-ray examination of the breast. It is just one of the modalities used for breast imaging; ultrasound and magnetic resonance imaging (MRI) are incredibly valuable adjunct techniques and newer technologies are gradually being adopted, such as molecular breast imaging and dedicated breast computed tomography. Inevitably, we tend to associate the term breast imaging with breast screening. Although breast screening has its critics [3], there can be no doubt that breast cancer is a major health burden on a global scale; it is the second most common cancer in the world and is responsible for more female deaths than any other cancer type [4]. Within Australia, 1 in 8 women will be diagnosed with breast cancer by the age of 85 [5]. However, it is reassuring to note that mortality rates are decreasing despite the fact that incidence rates continue to rise and the diagnosis rates in young women are increasing [6].Mammography is considered to be the gold standard for breast screening, having an overall sensitivity of about 85% and specificity of 90% [7] in women aged 50-70. Breast imaging is challenging since it is necessary to detect and classify pathological details (microcalcifications and masses) against a background of fibrous tissue, which can vary considerably in radiological appearance depending on breast thickness and composition.Microcalcifications have a relatively high atomic number and density and hence high inherent and subject contrast. Unfortunately they are generally very small in size, ranging from 10 µm through to several mm [8]. Although masses are of moderate size (5-10 mm), detection of carcinoma is difficult since malignant tissue has negligible physical density difference from fibrous breast tissue, a similar attenuation coefficient and therefore low inherent contrast I'm sorry to lure you in with a joke for which I don't have a punchline; the answer is just one, yet there are 95 physicists in Australia and New Zealand who hold ACPSEM Certification in Mammography Equipment Testing [1]. To put this into perspective, there are only 41 medical physicists who hold ACPSEM Certification in Radiology [2].This raises the questions of why mammography is the only radiology modality to have its own certification process and why there is so much demand for this qualification. Having spent 12 years specialising in mammography physics, I'll attempt to answer these questions and look at how mammographic technology has changed over the years and how this has impacted the role of the medical physicist.

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Section: Advances In Technologymentioning

confidence: 54%

Section: Advances In Technologymentioning

confidence: 99%

How many physicists does it take to test a mammography unit?

Diffey¹

2017

Australas Phys Eng Sci Med

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“…Newer technology such as digital breast tomosynthesis may provide higher sensitivity and increase cancer detection rate compared with digital mammography because of its ability to remove overlapping glandular tissue, the main reason for both false-positive and -negative results with traditional mammography. [10][11][12][13][14] Although tomosynthesis requires breast compression similar to mammogram, the compression force may be lower without affecting image quality. 14 Further studies would be helpful to determine whether the benefits of the MammoPad used by Chan et al 8 could have further benefit in tomosynthesis.…”

Section: Mammography For Breast Cancer Detection In Hong Kongmentioning

confidence: 99%

Mammography for breast cancer detection in Hong Kong

Wong

Lui²

2016

Hong Kong Med J

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“…Digital breast tomosynthesis (DBT) is a three-dimensional imaging technique that may address some of the limitations that DM has, in particular problems related to overlapping tissue. Several recent studies have shown that the combination of DBT and DM improves the cancer detection rate [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Factors affecting recall rate and false positive fraction in breast cancer screening with breast tomosynthesis – A statistical approach

et al. 2015

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Link to publication Citation for published version (APA): Rosso, A., Lång, K., Petersson, I., & Zackrisson, S. (2015). Factors affecting recall rate and false positive fraction in breast cancer screening with breast tomosynthesis -A statistical approach. Breast, 24(5), 680-686. DOI: 10.1016680-686. DOI: 10. /j.breast.2015 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal AbstractIn this study, we investigate which factors affect the false positive fraction (FPF) for digital breast tomosynthesis (DBT) compared to digital mammography (DM) in a screening population by using classification and regression trees (C&RT) and binary marginal generalized linear models.The data was obtained from the Malmö Breast Tomosynthesis Screening Trial, which aimed to compare the performance of DBT to DM in breast cancer screening. By using data from the first half of the study population (7 500 women), a tree with the recall probability for different groups was calculated. The effect of age and breast density on the FPF was estimated using a binary marginal generalized linear model.Our results show that breast density and breast cancer were the main factors influencing recall. The FPF is mainly affected by breast density and increases with breast density for DBT and DM.In conclusion, the results obtained with C&RT are easy to interpret and similar to those obtained using binary marginal generalized linear models. The FPF is approximately 40% higher for DBT compared to DM for all breast density categories.

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Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography

Abstract: Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate. Further studies are needed to assess the relationship to clinical outcomes.

Cited by 732 publications

References 18 publications

How many physicists does it take to test a mammography unit?

How many physicists does it take to test a mammography unit?

Mammography for breast cancer detection in Hong Kong

Factors affecting recall rate and false positive fraction in breast cancer screening with breast tomosynthesis – A statistical approach

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