CHICAGO — Researchers found that the use of 3-dimensional tomosynthesis (3DT) compared with 2-dimensional mammography (2DM) as initial follow-up imaging in breast conservation therapy reduced costs and excess workup. These findings were revealed during a poster presentation at the 2019 American Society of Clinical Oncology (ASCO).

The researchers reviewed 450 patients who underwent breast conservation therapy between 2015 and 2017. One hundred sixty-two patients underwent 3DT and 288 patients underwent 2DM. The primary end point of the study was further workup after follow-up mammography and associated healthcare costs at 1 year. The cost for one 3DT examination was estimated to be $149 compared with $111 for a 2DM examination.

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“There were no differences in breast density, patient age, T/N stage, receptor status, type of [radiotherapy], or mammography timing between those in the 2DM or 3DR groups,” the authors wrote.

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When comparing downstream workup between the 3DT and 2DM groups, the researchers noted 18% compared with 29% underwent 6-month mammography (odds ratio [OR] = 1.83; P =.01) and 6% compared with 11% underwent breast MRI (OR = 1.90; P =.08). Ultrasound and biopsy occurred in 4% and 3%, respectively. When considering the downstream workup, the estimated cost per patient was $249 and $253.64 for the 3DT group and 2DM group, respectively.

The multivariable analysis revealed that use of 3DT and follow-up mammography at least 6 months after radiation treatment were independent predictors for  reduced downstream workup.

Despite the fact that 3DT is known  to be more expensive than 2DM, the researchers’ findings and analysis of downstream effect show that it is ultimately a more cost effective option.


Hasan S, Gresswell S, Colosimo B, et al. Followup mammography after breast conservation therapy: Is 3D tomosynthesis (3DT) worth it? Presented at: 2019 ASCO Annual Meeting; June 1, 2019; Chicago, IL. Abstract 6628.