A new digital breast tomosynthesis technique has the potential to reduce the rate at which women are called back for additional examinations without sacrificing cancer detection, according to a study published in Radiology.1
In 2011, the U.S. Food and Drug Administration approved digital breast tomosynthesis (DBT) for use with full-field digital mammography (FFDM) in breast imaging. When used with FFDM, DBT has been shown to improve cancer detection and reduce callbacks for additional examinations. However, the combination of the 2 methods requires a second radiation exposure to the breast and also slightly more time for women in breast compression.
Researchers have been exploring a relatively new approach in which the DBT images are used to create a synthesized 2-D (s2D) compilation image. The method has the potential to render FFDM unnecessary. Investigators compared the clinical performance of DBT-s2D with that of DBT-FFDM and FFDM alone. They studied 78,810 screening mammograms performed from 2011 to 2016. In the study group, 32,076 women were screened with FFDM, 30,561 women were screened using DBT-FFDM, and 16,173 women were screened using DBT-s2D.
The study demonstrated that DBT-s2D’s recall rate was only 4.3% compared with 5.8% for DBT-FFDM. Overall cancer detection rates were similar. However, DBT-s2D detected 76.5% of invasive cancers compared with 61.3% for DBT-FFDM. At 3.6%, the false ̶positive rate for DBT-s2D was significantly lower than the 5.2% rate for DBT-FFDM. The positive predictive value of biopsy for DBT-s2D was 40.8% compared to 28.5% for DBT-FFDM.
1. Aujero MP, Gavenonis SC, Benjamin R, et al. Clinical Performance of Synthesized Two-dimensional Mammography Combined with Tomosynthesis in a Large Screening Population. Radiology. 2017 Feb 21:162674. doi: 10.1148/radiol.2017162674 [Epub ahead of print]