Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts – a systematic review and meta-analysis

Phi, Xuan-Anh; Tagliafico, Alberto; Houssami, Nehmat; Greuter, Marcel J W; Bock, Geertruida H. de

doi:10.1186/s12885-018-4263-3

Cited by 113 publications

(67 citation statements)

References 31 publications

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“…There is some evidence to support improved cancer detection (higher sensitivity) and reduced recall rates (specificity) in women with dense breasts screened with DBT relative to DM 14,15 . We did not find any studies comparing findings stratified by breast density for interval cancers identified after DM or DBT.…”

Section: Discussionmentioning

confidence: 67%

Comparison of interval breast cancers with 2D digital mammography versus 3D digital breast tomosynthesis in a large community‐based practice

et al. 2020

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Incidence of interval cancers is an important outcome in assessing efficacy of screening. Our primary objective was to compare the incidence of interval cancers detected with two‐dimensional digital mammography (DM) versus digital breast tomosynthesis (DBT) in a large community health system. Our secondary objectives were to compare the patient and tumor characteristics of interval cancers, cancer detection rate, and recall rate. Interval cancers before and after implementation of DBT (2012‐2014 DM group; 2016‐2018 DBT group) were reviewed. Patient factors (age, race, breast density, personal history of breast cancer, family history of breast cancer, known BRCA‐1 or BRCA‐2 genetic mutation, baseline mammogram, and presentation) and tumor characteristics (in situ versus invasive, grade, size, hormone receptor status, and nodal status) were compared with the chi‐squared test or the MidP exact test. Rates (detection and recall) were compared using a z‐score. The rates of interval cancers with DM (0.30 per 1000 [35/117 099]) and DBT (0.33 per 1000 [40/119 746]) were similar (P = .3). Proportion of node‐positive interval cancers was lower in the DBT group (22.9% [8/35] vs 48% [15/31], p.01). Otherwise, the patient and tumor characteristics were similar. The cancer detection rate increased (5.9 per 1000 [709/119 746] vs 3.5 per 1000 [411/117 099], P = .0001), and the recall rate decreased with DBT (8.6% [10 347/119 746] versus 10.7% [12 508/117 099], (P < .0001). Although the cancer detection rate was higher with DBT, the rate of interval breast cancers was similar in both groups. Node‐positive invasive interval cancers were decreased with DBT.

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Section: Discussionmentioning

confidence: 67%

Comparison of interval breast cancers with 2D digital mammography versus 3D digital breast tomosynthesis in a large community‐based practice

et al. 2020

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“…The 3D image allows radiologists to look through the breast, eliminating the influence of superposition (ie, overlapping layers of breast tissue that can obscure the ability to see cancer or give the appearance of an abnormality when none is present). Studies to date trend in the direction of showing that DBT has superior, or at least equivalent, performance compared with 2D mammography in terms of both sensitivity and specificity and appears to have some additional advantages compared with FFDM in screening performance among women with mammographically dense breasts, defined as a mammographic density >50% . A large prospective trial comparing FFDM versus DBT has been launched to determine whether DBT is superior to FFDM in reducing the detection rate of advanced breast cancer…”

Section: Breast Cancermentioning

confidence: 99%

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

Wender

Brawley

Fedewa

et al. 2018

CA A Cancer J Clinicians

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From the mid‐20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidity, and mortality. However, as new discoveries portend advancements in technology and risk‐based screening, we fail to fulfill the greatest potential of the existing technology, in terms of both full access among the target population and the delivery of state‐of‐the art care at each crucial step in the cascade of events that characterize successful cancer screening. There also is insufficient commitment to invest in the development of new technologies, incentivize the development of new ideas, and rapidly evaluate promising new technology. In this report, the authors summarize the status of cancer screening and propose a blueprint for the nation to further advance the contribution of screening to cancer control.

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“…Box 1 summarises some of the key scientific facts regarding BD. Early evidence suggests that supplemental (adjunct) screening in women with dense breasts detects additional breast cancers not detected on mammography (4, 15, 16). Specifically, there is early evidence that breast ultrasound and digital breast tomosynthesis detect additional cancers following ‘negative’ mammography screening; estimates of increased cancer detection and the associated increase or decrease in recall rates from supplemental imaging for women with dense breasts varies by imaging modality as summarised in systematic reviews (4, 16).…”

Section: Introductionmentioning

confidence: 99%

The impact of legislation mandating breast density notification – Review of the evidence

Houssami

Lee

2018

The Breast

Self Cite

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Breast density (BD) is an independent risk factor for breast cancer and reduces the sensitivity of mammography. The enactment of BD legislation in a majority of states in the USA mandating notification of risks associated with BD directly to women undergoing mammography has catapulted interest in BD among women, physicians, and policymakers. We therefore report a descriptive review of the evidence on the impact of enactment of BD legislation. Based on 22 eligible studies, we identified four broad themes of research: studies of the impact on screening rates, most showing increased utilisation of supplemental screening; studies exploring the effect on women, radiologists, or primary physicians (reporting heterogeneous effects on knowledge, awareness, perceptions, attitudes and behaviour; and changes in practice); few studies assessing the population impact (effect on screening outcomes or breast cancer stage); and studies of costs highlighting the economic burden from supplemental screening. Given that many of the studies were retrospective single institution studies (comparing pre- and post-legislation) or small surveys with a paucity of population-level studies, we highlight areas meriting additional research. The information described in this review can inform research priorities where BD legislation has been introduced and can be used to guide world-wide policy or practice decisions where BD legislation may be under debate or contemplation.

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Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts – a systematic review and meta-analysis

Cited by 113 publications

References 31 publications

Comparison of interval breast cancers with 2D digital mammography versus 3D digital breast tomosynthesis in a large community‐based practice

Comparison of interval breast cancers with 2D digital mammography versus 3D digital breast tomosynthesis in a large community‐based practice

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

The impact of legislation mandating breast density notification – Review of the evidence

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