Adoption of Breast Tomosynthesis Varies by Region

Use of digital breast tomosynthesis varies across the country and among practices, but is most often used clinically.

Digital breast tomosynthesis (DBT) is not used consistently throughout the country, according to a study published in the Journal of the American College of Radiology.

Researchers from the University of Denver in Colorado created an online survey to assess how DBT was used and the criteria used by physicians to offer DBT to patients. The survey, which included questions about the availability of DBT at the participant's practice, whether DBT was used for clinical care or research, clinical decision rules guiding patient selection for DBT, costs associated with DBT, plans to obtain DBT, and breast imaging practice characteristics, was sent to 670 members of the Society of Breast Imaging.

The response rate to the survey was 37 percent. Two hundred physicians (30 percent) reported using DBT, with 89 percent of these using DBT clinically. DBT was used most often in academic practices, in practices that had more than three breast imagers and in practices that had seven or more mammography units.

“Criteria used to select patients to undergo DBT varied, with 107 (68.2 percent) using exam type (screening versus diagnostic), 25 (15.9 percent) using mammographic density, and 25 (15.9 percent) using breast cancer risk,” the authors wrote. Looking at costs, the fees for DBT ranged from $25 to $250. Among nonusers, 62.3 percent planned to obtain DBT.

The researchers found a geographic difference in DBT use. Practices in the northeast and west were more likely to use DBT:

Percentage using DBT
36.9 percent
32.8 percent
25 percent
18.4 percent

The researchers concluded that use of DBT varied considerably throughout the country. “Clinical guidelines would assist practices in deciding whether to adopt DBT and in standardizing which patients should receive DBT,” they wrote.

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