Breast Tomosynthesis Increases Cancer Detection Over Digital Mammography

Leesburg, VA, October 16, 2019An ahead-of-print article in the March issue of the American Journal of Roentgenology (AJR) comparing cancer detection rates (CDR) for screening digital breast tomosynthesis (DBT) versus full-field digital mammography (FFDM) found that DBT results in “significantly increased CDR”—irrespective of tumor type, size, or grade of cancer.

Reviewing consecutive screening examinations performed between October 2012 and September 2014 at a large academic breast imaging practice, Pragya A. Dang and researchers at Brigham and Women’s Hospital in Boston detected 61 cancers in the matched cohort of DBT (n = 9817) and FFDM (n = 14,180) examinations. 

CDR measured higher with DBT than with FFDM for invasive cancers (2.8 vs 1.3, p = 0.01), minimal cancers (2.4 vs 1.2, p = 0.03), estrogen receptor–positive invasive cancers (2.6 vs 1.1, p = 0.01), and node-negative invasive cancers (2.3 vs 1.1, p = 0.02.), respectively. 

However, the ratio of screen-detected invasive cancers to ductal carcinoma in situ on DBT (3.0) was not significantly different from that on FFDM (2.6) (p = 0.79).

Where CDR were not statistically significant for DBT and FFDM, Dang noted: “We were likely underpowered to show a significant difference because of the smaller number of cancers in these subgroups. For instance, CDR of moderately and poorly differentiated invasive cancers, and for all cancer sizes detected with DBT, was nearly twice that of FFDM, even though it was not statistically significant.”

As Dang concluded, “our results suggest that integrating DBT into clinical practice may detect overall more cancers than does FFDM, for all tumor sub-types, grades, sizes, and nodal statuses.”

Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiology society in the North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, AJR Live Webinars and Podcasts, topical symposia, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.