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Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast
Richard E Sharpe1, Shambavi Venkataraman1, Jordana Phillips1
1From the Department of Radiology, Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Shapiro Clinical Center, 4th Floor, Breast Imaging, Boston, MA 02215.
Radiology
|October 13, 2015
Summary
Digital breast tomosynthesis (DBT) screening reduced recall rates by 18.8% and increased cancer detection by 54.3% compared to 2D mammography. This advancement in breast cancer screening offers improved accuracy and patient selection.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Screening mammography is crucial for early breast cancer detection.
- Digital breast tomosynthesis (DBT) offers advanced imaging capabilities over traditional 2D mammography.
- Variations in recall and cancer detection rates (CDRs) exist across different screening modalities and patient demographics.
Purpose of the Study:
- To compare recall rates (RR) and CDRs between DBT and 2D mammography.
- To analyze RR variations based on patient age, risk factors, and breast density.
- To assess radiologist-specific variations in RR during breast cancer screening.
Main Methods:
- Prospective study with retrospective cohort of 85,852 asymptomatic women undergoing screening mammography.
- Comparison of outcomes between 5,703 DBT examinations and 80,149 2D mammography examinations.
- Statistical analyses including logistic regression and chi-squared tests to evaluate RR and CDR differences.
Main Results:
- DBT detected 54.3% more cancers than 2D mammography (1.9 per 1000).
- DBT demonstrated a significantly lower overall RR (6.10%) compared to 2D mammography (7.51%), a relative decrease of 18.8%.
- Lower RRs were observed with DBT for patients with dense breasts and those in their 5th and 7th decades.
Conclusions:
- DBT implementation significantly reduces screening recall rates while increasing cancer detection rates.
- DBT shows promise for improved patient selection and may encourage wider adoption and reimbursement.
- These findings support DBT as a valuable tool for enhancing breast cancer screening efficacy.
