Recall Down, Cancer Detection Up With Digital Breast Tomosynthesis

THURSDAY, March 7, 2019 — Digital breast tomosynthesis (DBT) is associated with lower recall and higher cancer detection rates than digital mammography (DM), according to research published online Feb. 28 in JAMA Oncology.

Emily F. Conant, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective analysis of prospective cohort data from three research centers that included information for women aged 40 to 74 years who underwent screening examinations using DM and DBT. Data were included for 96,269 women with 180,340 breast cancer screening examinations.

The researchers found that 71.7 and 28.3 percent of the breast cancer screening examinations used DM and DBT, respectively. Compared with DM, DBT screening correlated with detection of smaller, more often node-negative, human epidermal growth factor receptor 2-negative, invasive cancers. For all age groups, DBT was associated with lower recall and higher cancer detection (odds ratios, 0.64 and 1.41, respectively) compared with DM, even when stratified by breast density. For women aged 40 to 49 years, DBT correlated with the largest increase in cancer detection rate and greatest shift toward smaller node-negative invasive cancers detected. DBT screening was associated with 25.0 percent of breast cancers classified as poor prognosis compared with 40.4 percent with DM screening among these younger women.

“These findings suggest that, in the subgroup of women aged 40 to 49 years, routine mammographic screening may be associated with a favorable risk-benefit ratio,” the authors write.

Several authors disclosed financial ties to the medical device industry.

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Posted: March 2019

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