Digital breast tomosynthesis: A new standard of care for breast cancer screening?

In April 2024, the US Preventive Services Task Force (USPSTF) published updated practice guidelines for breast cancer screening. For the first time, these guidelines recommend screening with either digital mammography (DM) or digital breast tomosynthesis (DBT), without preference for one modality over the other. DBT is a relatively new radiologic technology that produces 3-dimensional images of the breast. The objective of this clinical review is to provide an overview of DBT risks, benefits, and alternatives to support clinicians in incorporating DBT into their breast cancer screening protocols when appropriate. This review examines contemporary literature, including the recently published clinical trial results, and compares DBT with DM across key performance metrics such as sensitivity, specificity, cancer detection rate, and effects on morbidity and mortality. This review includes prospective, randomized trials, meta-analyses, and systematic reviews completed between 2017 and 2022. Overall, the available evidence suggests that DBT offers promising improvements in breast cancer diagnosis compared with DM alone and that it has the potential to play an increasingly prominent role in breast cancer screening protocols.