Tomosynthesis reduces recall rate in breast screening

Combining tomosynthesis with digital mammography lowered recall rates by 30% among women being screened for breast cancer, with the greatest reductions seen in patients younger than age 50 years and in those with dense breasts. 

As noted in a statement from the Radiological Society of North America (RSNA), tomosynthesis allows for three-dimensional reconstruction of the breast tissue, which can then be viewed as sequential slices through the breast, making tumors more apparent and false-positive findings less likely.

A review of all patients (13,158) presenting for screening mammography at four clinical sites between October 2011 and September 2012 showed that 6,100 received digital tomosynthesis in addition to digital mammography. The remaining patients underwent conventional digital mammography alone.

The overall recall rate was 8.4% for patients in the tomosynthesis group and 12% for those screened by conventional digital mammography, reported Brian M. Haas, MD, of the Yale University School of Medicine in New Haven, Connecticut, and fellow investigators in the RSNA journal Radiology. The increased cancer detection rate in the tomosynthesis group was insignificant: 5.7 per 1,000 patients receiving tomosynthesis compared with 5.2 per 1,000 patients receiving conventional mammography alone.

The addition of tomosynthesis reduced recall rates for all breast-density groups and for all patient-age groups, with particular benefits seen for patients with dense breasts and for those younger than age 50.

Tomosynthesis uses a radiation dose approximately double that of digital mammography alone. However, new technology approved by the FDA could reduce the radiation dose, Haas pointed out in the RSNA statement.

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