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Implementation of Synthesized Two-dimensional Mammography in a Population-based Digital Breast Tomosynthesis
Samantha P Zuckerman1, Emily F Conant1, Brad M Keller1
1From the Breast Imaging Division, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein Place, Philadelphia, PA 19104.
Radiology
|July 29, 2016
Summary
Synthesized two-dimensional (s2D) mammography combined with digital breast tomosynthesis (DBT) shows similar cancer detection rates to traditional digital mammography/DBT screening. This s2D/DBT approach significantly reduces radiation dose while maintaining screening effectiveness.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Digital breast tomosynthesis (DBT) has improved mammography screening outcomes.
- Synthesized 2D (s2D) mammography offers a potential alternative to traditional 2D mammography in DBT protocols.
- Evaluating early implementation of s2D/DBT is crucial for understanding its clinical utility.
Purpose of the Study:
- To assess the initial performance of s2D/DBT screening.
- To compare recall rates and cancer detection rates of s2D/DBT with historical digital mammography/DBT data.
- To evaluate radiation dose differences between the two screening modalities.
Main Methods:
- Retrospective analysis of prospectively acquired screening mammography data.
- Comparison of screening outcomes (recall rate, biopsy rate, cancer detection rate) between 15,571 women screened with digital mammography/DBT and 5,366 women screened with s2D/DBT.
- Statistical analysis using two-sample z tests of equal proportions.
Main Results:
- The s2D/DBT group had a lower recall rate (7.1% vs 8.8%) and biopsy rate (1.3% vs 2.0%) compared to digital mammography/DBT (P < .001 for both).
- Cancer detection rates were comparable between s2D/DBT and digital mammography/DBT (5.03/1000 vs 5.45/1000, P = .72).
- Average glandular dose was significantly lower with s2D/DBT (4.88 mGy vs 7.97 mGy, a 39% reduction, P < .001).
Conclusions:
- Early implementation of s2D/DBT in a large urban practice yields comparable cancer detection to digital mammography/DBT.
- s2D/DBT provides the benefits of DBT with a significant reduction in radiation exposure.
- s2D/DBT represents an effective and safer alternative for breast cancer screening.
