3D screening mammography detects 34% more breast cancers

  • Zackrisson S & al.
  • Lancet Oncol
  • 12 oct. 2018

  • Par Miriam Davis, PhD
  • Résumés d'articles
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Takeaway

  • 1-view digital breast tomosynthesis with reduced compression force showed higher sensitivity and slightly lower specificity vs conventional 2-view digital mammography in the large Swedish cohort study, the Malmo Breast Tomosynthesis Screening Trial (MBTST).
  • This led to a 34% higher breast cancer detection rate, accompanied by a higher recall rate. 

Why this matters

  • Tomosynthesis had mostly better diagnostic features with the potential for radiation dose reduction and lower screen-reading burden.

Study design

  • Population-based, prospective screening study of 14,851 women aged 40-74 years who received both screening methods.
  • Each screening method was read by a committee of 7 masked radiologists, and results were compared with surgery, core-needle biopsy, or medical records.
  • Funding: Swedish Cancer Society; Swedish Research Council; Breast Cancer Foundation.

Key results

  • Tomosynthesis (vs conventional mammography) had higher sensitivity (81.1% [95% CI, 74.2%-86.9%] vs 60.4% [95% CI, 52.3%-68.0%], respectively; no P-value given) yet slightly lower specificity (97.2% [95% CI, 97.0%-97.5%] vs 98.1% [95% CI, 97.9%-98.3%]; no P-value given).
  • Tomosynthesis had a 34% higher cancer detection rate per 1000 women screened (8.7 vs 6.5; P<.0001>
  • Tomosynthesis had higher recall rate (3.6% vs 2.5%; P<.0001>

Limitations

  • Tomosynthesis has limitations for dense breasts.
  • Single-institution study.