Association of Digital Breast Tomosynthesis vs Digital Mammography With Cancer Detection and Recall Rates by Age and Breast Density

Conant, Emily F.; Barlow, William E.; Herschorn, Sally D.; Weaver, Donald L.; Beaber, Elisabeth F.; Tosteson, Anna N.A.; Haas, Jennifer S.; Lowry, Kathryn P.; Stout, Natasha K.; Trentham‐Dietz, Amy; diFlorio-Alexander, Roberta; Li, Christopher I.; Schnall, Mitchell D.; Onega, Tracy; Sprague, Brian L.

doi:10.1001/jamaoncol.2018.7078

Cited by 156 publications

(119 citation statements)

References 24 publications

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“…There is some evidence to support improved cancer detection (higher sensitivity) and reduced recall rates (specificity) in women with dense breasts screened with DBT relative to DM 14,15 . We did not find any studies comparing findings stratified by breast density for interval cancers identified after DM or DBT.…”

Section: Discussionmentioning

confidence: 67%

Comparison of interval breast cancers with 2D digital mammography versus 3D digital breast tomosynthesis in a large community‐based practice

et al. 2020

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Incidence of interval cancers is an important outcome in assessing efficacy of screening. Our primary objective was to compare the incidence of interval cancers detected with two‐dimensional digital mammography (DM) versus digital breast tomosynthesis (DBT) in a large community health system. Our secondary objectives were to compare the patient and tumor characteristics of interval cancers, cancer detection rate, and recall rate. Interval cancers before and after implementation of DBT (2012‐2014 DM group; 2016‐2018 DBT group) were reviewed. Patient factors (age, race, breast density, personal history of breast cancer, family history of breast cancer, known BRCA‐1 or BRCA‐2 genetic mutation, baseline mammogram, and presentation) and tumor characteristics (in situ versus invasive, grade, size, hormone receptor status, and nodal status) were compared with the chi‐squared test or the MidP exact test. Rates (detection and recall) were compared using a z‐score. The rates of interval cancers with DM (0.30 per 1000 [35/117 099]) and DBT (0.33 per 1000 [40/119 746]) were similar (P = .3). Proportion of node‐positive interval cancers was lower in the DBT group (22.9% [8/35] vs 48% [15/31], p.01). Otherwise, the patient and tumor characteristics were similar. The cancer detection rate increased (5.9 per 1000 [709/119 746] vs 3.5 per 1000 [411/117 099], P = .0001), and the recall rate decreased with DBT (8.6% [10 347/119 746] versus 10.7% [12 508/117 099], (P < .0001). Although the cancer detection rate was higher with DBT, the rate of interval breast cancers was similar in both groups. Node‐positive invasive interval cancers were decreased with DBT.

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Section: Discussionmentioning

confidence: 67%

Comparison of interval breast cancers with 2D digital mammography versus 3D digital breast tomosynthesis in a large community‐based practice

et al. 2020

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“…With addition of breast ultrasound and other tools including MRI, screening's sensitivity surpasses 90%. Digital tomosynthesis, popularly known as 3D mammography, will further improve screening's accuracy [101], along with artificial intelligence.…”

Section: Long-term Outcomes Aōer Estrogen Receptor Posiɵve Breast Cancermentioning

confidence: 99%

Correcting a decade of negative news about mammography

Schattner

2020

Clinical Imaging

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It's been ten years since the U.S. Preventive Services Task Force pulled back on recommendations for breast cancer screening in women ages 40-49 years. After a decade of negative reports, most physicians are aware of mammography's limits. Today, many women avoid, delay or deliberately skip getting screened. As invasive breast cancer rates have been rising, and breast cancer remains a leading cause of death, truthful information about screening is critical for public health. Unfortunately, many reports about mammography exaggerate its harms and overestimate overdiagnosis. The public should be aware of current evidence supporting the benefit of breast cancer screening, including a 40% decline in the U.S. mortality rate in the mammography era. Delayed diagnosis has a downside, about which women should be informed. Contrary to popular views, breast cancer stage remains a key determinant of long-term prognosis. For the most common form of breast cancer, small tumor size and lack of lymph node involvement portend significantly better outcomes than larger tumors with positive nodes. Although mammography is not full-proof, the technology continues to improve; it is currently the best tool for finding breast cancer before it is greater than 2 centimeters or has spread. Interdisciplinary discussion of this topic by primary care physicians, oncologists, radiologists, public health experts, pathologists, and patient advocates would serve women's health.

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“…Uptake of the new technology has been based largely on superior detection rates in women with dense breasts and the reported test characteristics of superior sensitivity and specificity over traditional 2D mammography 7…”

mentioning

confidence: 99%