Comparing Screening Outcomes for Digital Breast Tomosynthesis and                    Digital Mammography by Automated Breast Density in a Randomized Controlled                    Trial: Results from the To-Be Trial

Moshina, Nataliia; Aase, Hildegunn Siv; Danielsen, Anders Skyrud; Haldorsen, Ingfrid S.; Lee, Christoph I.; Zackrisson, Sophia; Hofvind, Solveig

doi:10.1148/radiol.2020201150

Cited by 21 publications

(8 citation statements)

References 33 publications

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“…The program invites women aged 50-69 years to two-view mammography biennially. The screening program and the trial is described in detail elsewhere [17,[29][30][31].…”

Section: Methodsmentioning

confidence: 99%

Mammographic features and screening outcome in a randomized controlled trial comparing digital breast tomosynthesis and digital mammography

Aase

Danielsen

Hoff

et al. 2021

European Journal of Radiology

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“…The program invites women aged 50-69 years to two-view mammography biennially. The screening program and the trial is described in detail elsewhere [17,[29][30][31].…”

Section: Methodsmentioning

confidence: 99%

Mammographic features and screening outcome in a randomized controlled trial comparing digital breast tomosynthesis and digital mammography

Aase

Danielsen

Hoff

et al. 2021

European Journal of Radiology

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“…Both European [ 24 ] and American recommendations [ 25 ] dichotomized breast density categories. Two studies with more detailed density sub-analyses with automatic breast density assessment that analyzed data from prospective trials, the Oslo Tomosynthesis Screening Trial [ 14 ] and Tomosynthesis trial in Bergen [ 15 ], did not find a significantly higher CDR for DBT compared with DM for women with the densest breasts. However, in the Oslo Tomosynthesis Screening Trial, the higher CDR for the densest group with DBT compared to DM was of similar magnitude (21.7% (95% CI 3.0–41.9), p = 0.06) as the incremental rate for the subgroup with the second highest breast density (22.6% (95% CI 12.9–32.9), p < 0.001) [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of breast density on diagnostic accuracy in digital breast tomosynthesis versus digital mammography: results from a European screening trial

Olinder,

Johnson,

Åkesson

et al. 2023

Breast Cancer Res

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Background The diagnostic accuracy of digital breast tomosynthesis (DBT) and digital mammography (DM) in breast cancer screening may vary per breast density subgroup. The purpose of this study was to evaluate which women, based on automatically assessed breast density subgroups, have the greatest benefit of DBT compared with DM in the prospective Malmö Breast Tomosynthesis Screening Trial. Materials and methods The prospective European, Malmö Breast Tomosynthesis Screening Trial (n = 14,848, Jan. 27, 2010–Feb. 13, 2015) compared one-view DBT and two-view DM, with consensus meeting before recall. Breast density was assessed in this secondary analysis with the automatic software Laboratory for Individualized Breast Radiodensity Assessment. DBT and DM’s diagnostic accuracies were compared by breast density quintiles of breast percent density (PD) and absolute dense area (DA) with confidence intervals (CI) and McNemar’s test. The association between breast density and cancer detection was analyzed with logistic regression, adjusted for ages < 55 and ≥ 55 years and previous screening participation. Results In total, 14,730 women (median age: 58 years; inter-quartile range = 16) were included in the analysis. Sensitivity was higher and specificity lower for DBT compared with DM for all density subgroups. The highest breast PD quintile showed the largest difference in sensitivity and specificity at 81.1% (95% CI 65.8–90.5) versus 43.2% (95% CI 28.7–59.1), p < .001 and 95.5% (95% CI 94.7–96.2) versus 97.2% (95% CI 96.6–97.8), p < 0.001, respectively. Breast PD quintile was also positively associated with cancer detected via DBT at odds ratio 1.24 (95% CI 1.09–1.42, p = 0.001). Conclusion Women with the highest breast density had the greatest benefit from digital breast tomosynthesis compared with digital mammography with increased sensitivity at the cost of slightly lower specificity. These results may influence digital breast tomosynthesis’s use in an individualized screening program stratified by, for instance, breast density. Trial registration. Trial registration at https://www.ClinicalTrials.gov: NCT01091545, registered March 24, 2010.

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“… 26 In a trial in Norway, women were randomized to screening with digital breast tomosynthesis or digital mammography, and in women with Volpara density grade 4, no difference was found between the schemes in screen‐detection and false positive rates. 27 …”

Section: Discussionmentioning

confidence: 99%

Breast density and risk of breast cancer

Lynge

Vjeborg

Lillholm

et al. 2022

Intl Journal of Cancer

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Early studies reported a 4-to 6-fold risk of breast cancer between women with extremely dense and fatty breasts. As most early studies were case-control studies, we took advantage of a population-based screening program to study density and breast cancer incidence in a cohort design. In the Capital Region, Denmark, women aged 50 to 69 are invited to screening biennially. Women screened November 2012 to December 2017 were included, and classified by BI-RADS density code, version 4, at first screen after recruitment. Women were followed up for incident breast cancer, including ductal carcinoma in situ (DCIS), to 2020 in nationwide pathology data.Rate ratios (RRs) and 95% confidence intervals (CI) were compared across density groups using Poisson-regression. We included 189 609 women; 1 067 282 personyears; and 4110 incident breast cancers/DCIS. Thirty-three percent of women had BI-RADS density code 1; 38% code 2; 24% code 3; 4.7% code 4; and missing 0.3%.Using women with BI-RADS density code 1 as baseline; women with code 2 had RR 1.69 (95% CI 1.56-1.84); women with code 3, RR 2.06 (95% CI 1.89-2.25); and women with code 4, RR 2.37 (95% CI 1.05-2.74). Results differed between observations accumulated during screening and above screening age. Our results indicated less difference in breast cancer risk across level of breast density than normally stated. Translated into absolute risk of breast cancer after age 50, we found a 6.2% risk for the one-third of women with lowest density, and 14.7% for the 5% of women with highest density.

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Comparing Screening Outcomes for Digital Breast Tomosynthesis and Digital Mammography by Automated Breast Density in a Randomized Controlled Trial: Results from the To-Be Trial

Cited by 21 publications

References 33 publications

Mammographic features and screening outcome in a randomized controlled trial comparing digital breast tomosynthesis and digital mammography

Mammographic features and screening outcome in a randomized controlled trial comparing digital breast tomosynthesis and digital mammography

Impact of breast density on diagnostic accuracy in digital breast tomosynthesis versus digital mammography: results from a European screening trial

Breast density and risk of breast cancer

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