Digital Breast Tomosynthesis Valuable in Community Practice
Digital breast tomosynthesis (DBT) detected almost twice as many cancers as digital mammography and roughly 17% more invasive cancers, in community practice settings. In addition, the mean age at detection for DBT was lower than DM by 3 years, according to a study published September 15, 2021, in the American Journal of Roentgenology.
“A total of 310 cancers were detected in 47,096 screening DBT examinations and 83,200 screening DM examinations. Cancer detection rate was higher (p<.001) for DBT (3.4 per 1000 women) than DM (1.8 per 1000 women). [Positive predictive value] PPV1 was higher (p<.001) for DBT [3.5% (161/4641)] than DM [2.1% (149/7116)]. Age was lower (p=.02) for patients with screen-detected cancer by DBT (mean, 61 years; range, 40-87 years) than DM (mean, 64 years; range, 37-88 years). A greater percentage of DBT-detected than DM-detected cancers were invasive [85.1% (137/161) vs 72.5% (108/149), respectively; p=.006], grade 1 when invasive [27.9% (38/136) vs 17.8% (19/107), respectively; p=.04], and node negative [92.2% (71/77) vs 78.4% (58/74), respectively; p=.02]. Cancers detected by DBT and DM were not significantly different in histologic subtype, molecular subtype, or mean size (all p>.05),” found the team, led by Dr. Helena Regen-Tuero from Brown University.
The objective of the study was “[t]o compare DBT and DM in terms of screening performance and tumor characteristics of screen-detected cancers, in a community practice setting,” wrote the authors. They concluded, “[t]he findings support the generalizability of insights into DBT-based screening, which previously have been investigated primarily in academic settings.”
Regen-Tuero, Helaina C. and Ram, Shruthi and Gass, Jennifer S. and Lourenco, Ana P. Community-Based Breast Cancer Screening Using Digital Breast Tomosynthesis Versus Digital Mammography: Comparison of Screening Performance and Tumor Characteristics. American Journal of Roentgenology. Doi: 10.2214/AJR.21.26384 Published online September 15, 2021. Accessed September 27, 2021, at https://www.ajronline.org/doi/10.2214/AJR.21.26384