Comparison of Cancers Detected by Screening Breast Ultrasound and Digital Breast Tomosynthesis

Destounis, Stamatia; Arieno, Andrea; Santacroce, Amanda

doi:10.1016/j.acra.2021.01.008

Cited by 12 publications

(6 citation statements)

References 36 publications

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Section: Resultsmentioning

confidence: 99%

“…Recently, Destounis et al [ 38 ] evaluated the use of supplemental US in women with mammographically dense breasts who underwent DBT screening. Almost 96% (49 of 51) of cancers detected by US alone were invasive (49 invasive and 2 DCIS) [ 38 ], while most of the cancers detected on DBT alone were DCIS. Similarly, in a previous Adjunct Screening with Tomosynthesis or US in women with Mammography-Negative Dense Breasts (ASTOUND-2) trial [ 22 ], adjunct screening detected 27 additional invasive cancers: 12 (44%) detected on both DBT and US, 1 (4%) detected on DBT alone, and 14 (52%) detected on US alone.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Digital Breast Tomosynthesis Plus Ultrasound Versus Digital Mammography Plus Ultrasound for Screening Breast Cancer in Women With Dense Breasts

Yim

et al. 2023

Korean J Radiol

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Objective To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts. Materials and Methods A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared. Results A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40–78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8–19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7–15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%–34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%–24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%–28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%–18.9%; P < 0.001). Conclusion DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Digital Breast Tomosynthesis Plus Ultrasound Versus Digital Mammography Plus Ultrasound for Screening Breast Cancer in Women With Dense Breasts

Yim

et al. 2023

Korean J Radiol

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“…Across five prior series of prevalence screening DBT1US in women with dense breasts, encompassing 18,348 prevalence screens, [16][17][18][19][20] 50 cancers (2.7/1,000) were seen only on US. CDRs of 2.0 to 2.7 per 1,000 have been seen with prevalence screening after 2D mammography.…”

Section: Discussionmentioning

confidence: 99%

Prospective Multicenter Diagnostic Performance of Technologist-Performed Screening Breast Ultrasound After Tomosynthesis in Women With Dense Breasts (the DBTUST)

Berg

Zuley

Chang³

et al. 2023

JCO

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PURPOSE To assess diagnostic performance of digital breast tomosynthesis (DBT) alone or combined with technologist-performed handheld screening ultrasound (US) in women with dense breasts. METHODS In an institutional review board–approved, Health Insurance Portability and Accountability Act–compliant multicenter protocol in western Pennsylvania, 6,179 women consented to three rounds of annual screening, interpreted by two radiologist observers, and had appropriate follow-up. Primary analysis was based on first observer results. RESULTS Mean participant age was 54.8 years (range, 40-75 years). Across 17,552 screens, there were 126 cancer events in 125 women (7.2/1,000; 95% CI, 5.9 to 8.4). In year 1, DBT-alone cancer yield was 5.0/1,000, and of DBT+US, 6.3/1,000, difference 1.3/1,000 (95% CI, 0.3 to 2.1; P = .005). In years 2 + 3, DBT cancer yield was 4.9/1,000, and of DBT+US, 5.9/1,000, difference 1.0/1,000 (95% CI, 0.4 to 1.5; P < .001). False-positive rate increased from 7.0% for DBT in year 1 to 11.5% for DBT+US and from 5.9% for DBT in year 2 + 3 to 9.7% for DBT+US ( P < .001 for both). Nine cancers were seen only by double reading DBT and one by double reading US. Ten interval cancers (0.6/1,000 [95% CI, 0.2 to 0.9]) were identified. Despite reduction in specificity, addition of US improved receiver operating characteristic curves, with area under receiver operating characteristic curve increasing from 0.83 for DBT alone to 0.92 for DBT+US in year 1 ( P = .01), with smaller improvements in subsequent years. Of 6,179 women, across all 3 years, 172/6,179 (2.8%) unique women had a false-positive biopsy because of DBT as did another 230/6,179 (3.7%) women because of US ( P < .001). CONCLUSION Overall added cancer detection rate of US screening after DBT was modest at 19/17,552 (1.1/1,000; CI, 0.5- to 1.6) screens but potentially overcomes substantial increases in false-positive recalls and benign biopsies.

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“…Incremental cancer detection rates of screening ultrasound after 3D/tomosynthesis in women with mammographically negative dense breasts range from 2.6 to 3.4/1000 women screened. [21][22][23][24][25] Ultrasound is the most widely validated and most available supplemental screening for women with dense breast tissue not otherwise at high risk, 26 though nearly a quarter of respondents felt MRI should be considered. MRI, while more sensitive than ultrasound, 27 is currently only recommended for high-risk women (regardless of breast density), 28 women diagnosed with breast cancer by age 50, or diagnosed at any age and with dense breasts.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to over-reliance on 3D/tomosynthesis, knowledge gaps existed regarding the improvement in cancer detection provided by ultrasound after or compared to 3D/tomosynthesis, and consideration of its use in women with dense breasts at average breast cancer risk. Incremental cancer detection rates of screening ultrasound after 3D/tomosynthesis in women with mammographically negative dense breasts range from 2.6 to 3.4/1000 women screened 21-25 . Ultrasound is the most widely validated and most available supplemental screening for women with dense breast tissue not otherwise at high risk, 26 though nearly a quarter of respondents felt MRI should be considered.…”

Section: Discussionmentioning

confidence: 99%

Effect of an educational intervention on women's healthcare provider knowledge gaps about breast density, breast cancer risk, and screening

Seitzman¹,

Pushkin²,

Berg

2021

Menopause

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Comparison of Cancers Detected by Screening Breast Ultrasound and Digital Breast Tomosynthesis

Cited by 12 publications

References 36 publications

Digital Breast Tomosynthesis Plus Ultrasound Versus Digital Mammography Plus Ultrasound for Screening Breast Cancer in Women With Dense Breasts

Digital Breast Tomosynthesis Plus Ultrasound Versus Digital Mammography Plus Ultrasound for Screening Breast Cancer in Women With Dense Breasts

Prospective Multicenter Diagnostic Performance of Technologist-Performed Screening Breast Ultrasound After Tomosynthesis in Women With Dense Breasts (the DBTUST)

Effect of an educational intervention on women's healthcare provider knowledge gaps about breast density, breast cancer risk, and screening

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