Detect More Breast Cancers with Tomosynthesis and Mammography

Screening with tomosynthesis in conjunction with digital mammography lowers recall rates and increases cancer detection.

Adding tomosynthesis to digital mammography as part of the breast cancer screening process decreases recall rates and increases cancer detection rates, according to an article published in JAMA.

Researchers from multiple centers around the U.S. performed a retrospective analysis to determine if the combination of digital mammography and tomosynthesis would improve the performance of breast screening programs. This is the largest study of its kind, according to a release.

The researchers evaluated 454,850 examinations (281,187 digital mammography and 173,663 digital mammography plus tomosynthesis) from 13 centers for recall rate, cancer detection rate, positive predictive value for recall and positive predictive value for biopsy.

The study used Hologic 3D mammography (breast tomosynthesis), which is currently the only FDA-approved 3D mammography manufacturer.

The results showed that there was a decrease of 16 per 1,000 screens when digital mammography was combined with tomosynthesis. 

Digital mammography alone
Digital mammography plus tomosynthesis
Recall rate
Cancer detection
Invasive cancer detection
Positive predictive value for recall
4.3 percent
6.4 percent
Positive predictive value for biopsy
24.2 percent
29.2 percent












The system combined digital mammography and tomosynthesis-generated images, which provide a more detailed picture of the breast. The images are then used to produce a series of one-millimeter thick slices that can be viewed as a 3D reconstruction of the breast, according to a release.

The technology, which overlaps normal breast anatomy that may mimic or mask a tumor, gives radiologists the ability to identify and characterize individual breast structures and see features which might be obscured in a traditional mammogram, the release said.

Overall, the study found the addition of tomosynthesis provided a 41 percent increase in detection of invasive cancer; a 15 percent decrease in unnecessary recalls for false alarms; and a 29 percent increase in the detection of all breast cancers.

"The association with fewer unnecessary tests and biopsies, with a simultaneous increase in cancer detection rates, would support the potential benefits of tomosynthesis as a tool for screening. However, assessment for a benefit in clinical outcomes is needed," the authors wrote.

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