Implementation of breast tomosynthesis in a routine screening practice: an observational study

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Public Health

Background:

• Digital mammography with tomosynthesis is increasingly adopted clinically.
• Limited data exist on its real-world performance impact.
• Assessing changes in screening mammography performance measures is crucial.

Purpose of the Study:

• To evaluate the impact of introducing tomosynthesis on key performance measures in clinical mammography.
• To compare recall rates, biopsy rates, cancer detection rates, and positive predictive values before and after tomosynthesis implementation.

Main Methods:

• Observational study using verified practice and outcome databases.
• Compared performance metrics for six radiologists interpreting mammography with and without tomosynthesis.
• Statistical analyses accounted for reader variability, participant age, and examination baseline status.

Main Results:

• Significant reduction in recall rates from 8.7% to 5.5% (p < 0.001).
• Increase in overall cancer detection rate from 4.0 to 5.4 per 1000 screenings (p = 0.18).
• Significant increase in positive predictive value for recalls from 4.7% to 10.1% (p < 0.001).

Conclusions:

• Breast tomosynthesis introduction significantly decreased recall rates.
• Simultaneously, breast tomosynthesis was associated with an increase in breast cancer detection rates.
• Tomosynthesis improves the accuracy and effectiveness of breast cancer screening in clinical practice.