Digital breast tomosynthesis significantly increases cancer detection over full-field mammography

Leesburg, VA - Digital breast tomosynthesis significantly increases cancer detection over full-field mammography is finding of a new study. In an ahead-of-print article forthcoming in the March 2020 issue of the American Journal of Roentgenology (AJR) comparing cancer detection rates (CDR) for screening digital breast tomosynthesis (DBT) versus full-field digital mammography (FFDM) found that DBT results in "significantly increased CDR"--irrespective of tumor type, size, or grade of cancer.

The researchers conducted the study to compare the cancer detection rates (CDRs), tumor types, and characteristics between screening digital breast tomosynthesis (DBT) and screening full-field digital mammography (FFDM) in a matched patient population in a large academic breast imaging practice with mixed DBT and FFDM technology.

The researchers in this retrospective study, we reviewed consecutive screening FFDM and DBT examinations performed between October 2012 and September 2014. To control for nonrandomized selection of FFDM versus DBT examinations, we applied propensity score matching on the basis of patient age, imaging site, and prior imaging findings. An institutional breast cancer registry identified cancer diagnoses. CDR and tumor type, grade, receptor, nodal status, and size were compared between matched FFDM and DBT groups.

Cancer detection rates measured higher with DBT than with FFDM for invasive cancers (2.8 vs 1.3, p = 0.01), minimal cancers (2.4 vs 1.2, p = 0.03), estrogen receptor-positive invasive cancers (2.6 vs 1.1, p = 0.01), and node-negative invasive cancers (2.3 vs 1.1, p = 0.02.), respectively.

However, the ratio of screen-detected invasive cancers to ductal carcinoma in situ on Digital breast tomosynthesis (3.0) was not significantly different from that on FFDM (2.6) (p = 0.79).

Where CDR was not statistically significant for Digital breast tomosynthesis and FFDM, Dang noted: "We were likely underpowered to show a significant difference because of the smaller number of cancers in these subgroups. For instance, CDR of moderately and poorly differentiated invasive cancers, and for all cancer sizes detected with DBT, was nearly twice that of FFDM, even though it was not statistically significant."

As Dang concluded, "our results suggest that integrating DBT into clinical practice may detect overall more cancers than does FFDM, for all tumor subtypes, grades, sizes, and nodal statuses."