Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

Sharpe, Richard E.; Venkataraman, Shambavi; Phillips, Jordana; Dialani, Vandana; Fein‐Zachary, Valerie; Prakash, Suraj; Slanetz, Priscilla J.; Mehta, Tejas S.

doi:10.1148/radiol.2016164018

Cited by 35 publications

(40 citation statements)

References 12 publications

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“…The development of digital breast tomosynthesis (DBT), a pseudo-three-dimensional technique that minimizes the ambiguity of overlapping breast tissue (6), has decreased recall rates while increasing CDRs. When DBT is used in combination with digital mammography, studies have shown a 15%-40% decrease in recall rate (7)(8)(9)(10)(11)(12) and up to a 29% increase BREAST IMAGING: Screening Digital Mammography Recall Rate DiPrete et al separately analyzed. All six radiologists were fellowship-trained breast radiologists (including author A.P.L.)…”

Section: Implication For Patient Carementioning

confidence: 99%

Screening Digital Mammography Recall Rate: Does It Change with Digital Breast Tomosynthesis Experience?

et al. 2018

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Purpose To compare screening mammography recall rate, cancer detection rate (CDR), and positive predictive values (PPVs) for digital mammography before and after radiologist experience with digital breast tomosynthesis (DBT). Materials and Methods This retrospective study was approved by the institutional review board and compliant with HIPAA. The authors reviewed screening mammography audit data obtained from 2009 to 2014, during which 108 276 digital mammographic examinations were performed (50 062 before and 58 214 after experience with DBT). Recall rate, CDR, PPV of positive screening result (PPV), PPV of biopsy recommendation (PPV), and PPV of biopsies performed (PPV) of digital mammography for six radiologists were compared before (2009-2011) and after (2012-2014) experience with DBT. Radiologists worked in both a community setting, in which only digital mammography was available, and in two tertiary breast imaging centers, where they interpreted DBT images starting in 2012. Data were examined by using generalized linear mixed modeling wherein observations were nested for each radiologist over time. P < .05 was considered indicative of a statistically significant difference; 95% confidence intervals (CIs) were calculated. Results The average recall rate was 6.8% (range, 3.6%-9.7%) before experience with DBT and 7.9% (range, 5.5%-9.5%) after (P = .0316). Before experience with DBT, the recall rate increased only 0.01% for each year from 2009 to 2011 (P = .9727). After experience with DBT, the recall rate increased 0.65% for each year from 2012 to 2014 (P < .0127). CDR increased from 2.5 per 1000 examinations (95% CI: 2.2, 2.9) to 3.5 per 1000 examinations (95% CI: 3.0, 4.0; P = .0203). PPV and PPV increased significantly after experience with DBT, from 26.9% (95% CI: 19.9%, 35.3%) to 36.1% (95% CI: 31.7%, 40.7%; P = .0212) for PPV and from 31.2% (95% CI: 24.0%, 39.3%) to 40.0% (95% CI: 35.5%, 44.6%; P = .0290) for PPV. Conclusion Recall rate, CDR, PPV, and PPV of digital mammography increased after radiologist experience with DBT. RSNA, 2017.

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Section: Implication For Patient Carementioning

confidence: 99%

Screening Digital Mammography Recall Rate: Does It Change with Digital Breast Tomosynthesis Experience?

et al. 2018

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“…1). Sixteen studies [12,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] met our predefined inclusion criteria and were included in the evidence synthesis. The meta-analysis was performed separately for 5 diagnostic studies, and for 11 screening studies (these were examined separately for 8 screening studies that used two independent study groups, and the 3 screening studies that used one study group).…”

Section: Study Inclusionmentioning

confidence: 99%

“…All but two of 11 screening studies performed one screening round. Nine screening studies reported CDR [16,19,20,[23][24][25][26][27]29] and nine studies reported recall rate [16,19,20,22,24,[26][27][28][29].…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts – a systematic review and meta-analysis

Phi¹,

Tagliafico²,

Houssami³

et al. 2018

European Journal of Cancer

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Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. Methods: Two independent reviewers identified screening or diagnostic studies reporting at least one of four outcomes (cancer detection rate-CDR, recall rate, sensitivity and specificity) for DBT and DM in women with mammographically dense breasts. Study quality was assessed using QUADAS-2. Meta-analysis of CDR and recall rate used a random effects model. Summary ROC curve summarized sensitivity and specificity. Results: Sixteen studies were included (five diagnostic; eleven screening). In diagnosis, DBT increased sensitivity (84%-90%) versus DM alone (69%-86%) but not specificity. DBT improved CDR versus DM alone (RR: 1.16, 95% CI 1. 02-1.31). In screening, DBT + DM increased CDR versus DM alone (RR: 1.33, 95% CI 1.20-1.47 for retrospective studies; RR: 1.52, 95% CI 1.08-2.11 for prospective studies). Recall rate was significantly reduced by DBT + DM in retrospective studies (RR: 0.72, 95% CI 0.64-0.80) but not in two prospective studies (RR: 1.12, 95% CI 0.76-1.63). Conclusion: In women with mammographically dense breasts, DBT+/−DM increased CDR significantly (versus DM) in screening and diagnosis. In diagnosis, DBT+/−DM increased sensitivity but not specificity. The effect of DBT + DM on recall rate in screening dense breasts varied between studies.

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“…A mammography population-based screening programme can also be successfully integrated in a midlower income country and continues to be the only evidence-based screening tool to reduce breast-cancer-specific mortality (29). Increase of incremental cancer detection rate (around 2/1000 examinations) and absolute decrease of recall rate (about 1-1.5%) have been observed after implementation of 3D digital breast tomosynthesis in population-based screening trials (30)(31)(32)(33). Many logistical issues and the role of potential over-diagnosis of DCIS need further evaluation to determine the potential implications and cost of supplemental HHUS, SAUS, combined 2D + supplemental 3D mammographic screening (30)(31)(32)(33)(34)(35)(36).…”

Section: Evidence Based Medicine and Coverage For Supplemental Screeningmentioning

confidence: 99%

3D Supine Automated Ultrasound (SAUS, ABUS, ABVS) for Supplemental Screening Women with Dense Breasts

Mundinger¹

2016

J Breasth Health

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The latest re-analysis of ACRIN 6666 data by Berg and co-workers 2016 showed that cancer detection rate with handheld ultrasound (HHUS) is comparable with mammography, with a greater proportion of invasive and node-negative cancers among US detections (1). Supplemental screening by HHUS in addition to mammography in women with dense breasts results in additional screen detected cancer rates between 1.8 and 4.6 per thousand examinations depending on the basic risk of the collectives (2). Three-dimensional supine automated ultrasound (SAUS) of the breast, also known as 3D automated breast ultrasound (ABUS; trademarks of General Electric company; Invenia and somo v * ABUS) or 3D automated breast volume scanning (ABVS, trademark of Siemens company; ACUSON S2000™ automated breast volume scanner), represents an innovative technology that has gained FDA approval for screening or early detection of breast cancer in women with dense breasts; claiming to find 35.7% more cancers in women with dense breasts than mammography alone (3, 4). Can ABUS/ABVS really catch up with HHUS and other supplementary imaging methods in screening women with dense breasts? What is the future of population-based supplemental imaging in women at intermediate risk? 3D supine automated ultrasound (SAUS: ABUS, ABVS) -what is it?In contrast to HHUS a mechanical arm links the ABUS or ABVS transducer with the computing system. Patients lie supine. A technician performs several automated standardized scanning tracks of both breasts at a predefined speed. The resulting three-dimensional data sets co-register the US echo information with the corresponding voxel positions within the breast volume. Finally a physician reads the data on a workstation similar to reading a CT or MRI examinations in multiple planes and reconstructions (5). Multiplanar reconstructions of 3D automated breast ultrasound have been shown to improve lesion differentiation by radiologists (6). Modern prone water bath systems operate on the principles of ultrasound tomography. They incorporate multiple sound characteristics of reflection, sound speed, and attenuation of transmission ultrasound that can be sampled by a circular array surrounding the breast. Currently clinical studies have been initiated. However, population-based trials do not exist to date (4). Advantages of 3D supine automated ultrasound (SAUS)Older versions of the 3D supine automated ultrasound technology have been shown to be inferior to HHUS (5, 7), however updated technology has overcome previous problems to a large degree (8, 9). The newest generation of ABUS (Invenia ABUS; trademark of GE) is faster, achieves a higher resolution and generates less coupling artefacts between the curved transducer and the curved surface of the breast compared to older systems with a plane transducer surface (5). Compared to HHUS, 3D supine automated ultrasound of the breast provides for better detection of architectural distortions and hyperechoic rim in the coronal plane (10, 11). The complete, non-selective documentation of th...

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Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

Cited by 35 publications

References 12 publications

Screening Digital Mammography Recall Rate: Does It Change with Digital Breast Tomosynthesis Experience?

Screening Digital Mammography Recall Rate: Does It Change with Digital Breast Tomosynthesis Experience?

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts – a systematic review and meta-analysis

3D Supine Automated Ultrasound (SAUS, ABUS, ABVS) for Supplemental Screening Women with Dense Breasts

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