Can digital breast tomosynthesis perform better than standard digital mammography work-up in breast cancer assessment clinic?

Mall, Suneeta; Noakes, Jennie; Kossoff, Marjorie B.; Lee, W.; McKessar, Merran; Goy, A.; Duncombe, J.; Roberts, Michael; Giuffrè, Bruno; Miller, A. B.; Bhola, N.; Kapoor, Cassandra; Shearman, CP; DaCosta, G.; Choi, Sungwon; Štěrba, J; Kay, Meredith; Bruderlin, K.; Winarta, N.; Donohue, Kevin D.; Macdonell-Scott, B.; Klijnsma, F.; Suzuki, Kôjiro; Brennan, Patrick C.; Mello‐Thoms, Claudia

doi:10.1007/s00330-018-5473-4

Cited by 24 publications

(20 citation statements)

References 25 publications

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“…1 ). Finally, 20 articles with 44513 patients and 58388 lesions fulfilled the eligibility criteria [ 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 ]. Table 1 presents the characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, 50% were conducted in Asian countries [ 18 19 20 23 25 27 29 31 32 33 ], and there were four prospective studies [ 18 19 32 33 ]. Five studies had patients with breast density ≥ 2 or b according to American College of Radiology (ACR) [ 28 29 30 31 34 ], nine studies consecutively sampled participants [ 18 21 22 24 25 26 32 34 35 ], and 13 studies performed a per-lesion analysis [ 18 19 20 21 22 23 25 26 28 29 31 32 33 34 ]. Five studies included lesions without calcifications [ 26 28 29 30 34 ], and three studies symptomatic patients only [ 19 29 34 ].…”

Section: Resultsmentioning

confidence: 99%

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Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis

Park

Kim

et al. 2021

Korean J Radiol

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Objective To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86–0.93) and 0.90 (95% CI 0.84–0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68–0.83) and 0.83 (95% CI 0.73–0.89), respectively, for DM alone ( p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93–0.97) for DBT and 0.86 (95% CI 0.82–0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis

Park

Kim

et al. 2021

Korean J Radiol

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“…Results showed no improvement in observer performance with the addition of DBT. Later studies concluded that observer performance increases with the addition of DBT to DM when using more advanced Hologic models 13,16,35–43. Specifically in the detection and characterization of invasive lobular cancers, DM&DBT significantly increases sensitivity compared to DM alone 44…”

Section: Results: Studies On the Optimal Use Of Digital Breast Tomosymentioning

confidence: 99%

“…A lot of review work has been completed on the use of DBT in breast cancer screening 8,12,13. However, to the best of our knowledge, no review work has summarised clinical observer studies separately for each of the four common methods with which DBT can be implemented in screening: (2-view) DBT alone [DBT or 2vDBT],(2-view) DBT with (2-view) DM [DM&DBT],Single-view DBT [1vDBT] with or without single or double view DM [1vDM or 2vDM],(2-view) DBT with (2-view) SM [DBT&SM].…”

Section: Introductionmentioning

confidence: 99%

<p>The role of digital breast tomosynthesis in breast cancer screening: a manufacturer- and metrics-specific analysis</p>

Hadjipanteli

Kontos

Constantinidou

2019

CMAR

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Aim: Digital Breast Tomosynthesis (DBT), with or without Digital Mammography (DM) or Synthetic Mammography (SM), has been introduced or is under consideration for its introduction in breast cancer screening in several countries, as it has been shown that it has advantages over DM. Despite this there is no agreement on how to implement DBT in screening, and in many cases there is a lack of official guidance on the optimum usage of each commercially available system. The aim of this review is to carry out a manufacturerspecific summary of studies on the implementation of DBT in breast cancer screening. Methods: An exhaustive literature review was undertaken to identify clinical observer studies that evaluated at least one of five common metrics: sensitivity, specificity, area under the curve (AUC) of the receiver-operating characteristics (ROC) analysis, recall rate and cancer detection rate. Four common DBT implementation methods were discussed in this review: (1) DBT, (2) DM with DBT, (3) 1-view DBT with or without 1-view DM or 2-view DM and (4) DBT with SM. Results: A summary of 89 studies, selected from a database of 677 studies, on the assessment of the implementation of DBT in breast cancer screening is presented in tables and discussed in a manufacturer-and metric-specific approach. Much more studies were carried out using some DBT systems than others. For one implementation method of DBT by one manufacturer there is a shortage of studies, for another implementation there are conflicting results. In some cases, there is a strong agreement between studies, making the advantages and disadvantages of each system clear. Conclusion: The optimum implementation method of DBT in breast screening, in terms of diagnostic benefit and patient radiation dose, for one manufacturer does not necessarily apply to other manufacturers.

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“…In a retrospective study by Greenberg et al (26), 46 of 131 patients who underwent DBT (35.1%) had no additional mammographic views performed at recall (compared with 12 of 190 [6.3%] in the FFDM-only group), suggesting a more efficient recall assessment (P , .001). In the Tomosynthesis Assessment Clinic Trial (75), which involved 144 women, the use of DBT was associated with a significant reduction in the need for additional views (x 2 DBT plus SM (79), the estimated average glandular dose for a single mammographic view (6standard deviation) was 1.58 mGy 6 0.61 (range, 0.74-4.51 mGy) for FFDM and 1.95 mGy 6 0.58 (range, 1.05-3.78 mGy) for DBT. By replacing FFDM with SM in the DBT plus FFDM examination, the average glandular dose was decreased by approximately 45%, with the dose with DBT plus SM just 19% higher than that with FFDM alone (49).…”

Section: Practice Considerationsmentioning

confidence: 99%

Digital Breast Tomosynthesis: Concepts and Clinical Practice

et al. 2019

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Digital breast tomosynthesis (DBT) is emerging as the standard of care for breast imaging based on improvements in both screening and diagnostic imaging outcomes. The additional information obtained from the tomosynthesis acquisition decreases the confounding effect of overlapping tissue, allowing for improved lesion detection, characterization, and localization. In addition, the quasi three-dimensional information obtained from the reconstructed DBT data set allows a more efficient imaging work-up than imaging with two-dimensional full-field digital mammography alone. Herein, the authors review the benefits of DBT imaging in screening and diagnostic breast imaging.

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Can digital breast tomosynthesis perform better than standard digital mammography work-up in breast cancer assessment clinic?

Cited by 24 publications

References 25 publications

Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis

Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis

<p>The role of digital breast tomosynthesis in breast cancer screening: a manufacturer- and metrics-specific analysis</p>

Digital Breast Tomosynthesis: Concepts and Clinical Practice

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