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Digital breast tomosynthesis (DBT) shows sustained performance improvements, including lower recall rates, compared to digital mammography (DM). These benefits persist regardless of radiologist experience or breast density, indicating DBT

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Area of Science:

  • Radiology
  • Medical Imaging
  • Oncology

Background:

  • Digital breast tomosynthesis (DBT) is increasingly recognized for potentially improving recall and cancer detection rates over digital mammography (DM).
  • The impact of radiologist experience, or learning curve, on DBT performance has not been well-established.

Purpose of the Study:

  • To assess screening DBT performance based on cumulative interpreted DBT volume.
  • To compare DBT performance with prior DM performance within the same facilities.

Main Methods:

  • A prospective study analyzed 106,126 DBT and 221,248 DM examinations from 2010-2017 across 53 facilities.
  • 104 radiologists interpreted the screening exams.
  • Conditional logistic regression evaluated the effect of cumulative DBT volume on recall and cancer detection rates relative to DM, adjusting for covariates.

Main Results:

  • DBT adoption led to a lower recall rate (9.4%) compared to DM (10.4%), with similar cancer detection rates (4.6 vs. 4.0 per 1000 screenings).
  • Recall rates decreased with increasing cumulative DBT volume and remained lower than DM across all volume strata.
  • Performance improvements were consistent across radiologist subspecialties and were more pronounced in women with non-dense breasts.

Conclusions:

  • Early performance gains with DBT screening are sustained irrespective of cumulative interpreted volume.
  • DBT demonstrates consistent benefits in recall rate reduction across different radiologist expertise levels and breast densities.
  • Cancer detection rates remained comparable between DBT and DM throughout the study period.