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Assessing Digital Breast Tomosynthesis Impact on Early Cancer Detection: Insights from Consecutive Screening
Annika Jögi1, Kristin Johnson1, Sofia Wittgren1
1From the Department of Oncology and Radiotherapy, Skåne University Hospital, Klinikgatan 5, 222 42 Lund, Sweden (A.J.); Translational Cancer Research, Department of Laboratory Medicine, Lund University Cancer Center at Medicon Village, Lund University, Lund, Sweden (A.J.); Radiology Diagnostics, Department of Translational Medicine and Department of Imaging and Physiology (K.J., V.S., H.T., J.O., I.A., S.Z., P.R.B.) and Department of Radiation Physics (P.R.B.), Lund University, Skåne University Hospital; and Department of Imaging and Physiology (K.J., V.S., J.O., I.A., S.Z.) and Department of Rheumatology Lund (S.W.), Lund University Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden (S.W.); and Clinical Studies Sweden-Forum South, Skåne University Hospital, Malmö, Sweden (A.Å.).
Digital breast tomosynthesis (DBT) improves breast cancer screening by increasing cancer detection rates, particularly for invasive cancers. This technology aids in earlier detection, especially of luminal A-like cancers, enhancing screening performance over consecutive rounds.
Area of Science:
- Radiology and Imaging
- Oncology
- Public Health Screening
Background:
- Evaluating the impact of digital breast tomosynthesis (DBT) on subsequent screening performance is crucial for its future implementation.
- Understanding how DBT affects cancer detection rates (CDRs) and cancer subtypes in routine screening is essential.
Purpose of the Study:
- To assess if DBT enhances early breast cancer detection.
- To analyze changes in CDRs, invasive cancer fractions, and cancer subtypes in consecutive screening rounds following DBT participation.
Main Methods:
- A secondary analysis of the prospective Malmö Breast Tomosynthesis Screening Trial (MBTST) involving women undergoing one-view DBT and two-view digital mammography (DM).
- Follow-up through two subsequent two-view DM screening rounds (DM1 and DM2) to track cancer diagnoses.
- Logistic regression adjusted for age was used to compare odds of detecting luminal A-like cancers.
Main Results:
- Cancer detection rates were lower in DM1 and DM2 compared to the initial MBTST screening.
- The proportion of invasive cancers decreased in DM1 but returned to baseline levels in DM2.
- A significant decrease in the odds of detecting luminal A-like cancers was observed in DM1 compared to MBTST screening.
Conclusions:
- DBT screening appears to facilitate earlier cancer detection, primarily by increasing the identification of luminal A-like cancers.
- The observed trends in CDR and invasive cancer fractions suggest that DBT contributes to improved early detection outcomes in breast cancer screening.
