Could Digital Breast Tomosynthesis Provide Better Screening Than Digital Mammography?

By: Joshua Swore, PhD
Posted: Wednesday, November 16, 2022

Digital breast tomosynthesis may be a more effective screening method for women with dense breasts and at high risk of breast cancer than digital mammography, according to an article published in JAMA. “Digital breast tomosynthesis, available at 81% of U.S. breast imaging facilities, was developed with the expectation that it would decrease recall rate and improve breast cancer detection in women with dense breasts,” said Karla Kerlikowske, MD, of the University of California, San Francisco, and colleagues. “To our knowledge, this is the first study to document an association of lower likelihood of false-positive short-interval follow-up and false-positive biopsy with [digital breast tomosynthesis].”

A total of 504,427 women, aged 40 to 79, with a median age of 58 years, were included in the study population. The cohort underwent a total of 1,003,900 digital mammography and 375,189 digital breast tomosynthesis screenings from 2011 to 2018. Follow-up was conducted through 2019.

The researchers reported no significant difference in outcome between digital breast tomosynthesis and digital mammography screenings for interval invasive cancer rates per 1,000 examinations (.57 and .61 respectively, P = .43). However, outcomes of advanced cancer were lower for digital breast tomosynthesis than for digital mammography in women with breasts classified as extremely dense and with a high risk of breast cancer (.27 vs. .80 per 1,000, respectively). The authors reported that women at average to low risk did not have significantly different outcomes when screened with digital breast tomosynthesis or digital mammography (.54 vs. 0.42, respectively). These results suggest that digital breast tomosynthesis may be considered over digital mammography screenings in cases where women have a higher risk of breast cancer.

Disclosure: For full disclosures of the study authors, visit jamanetwork.com.

JAMA

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