Using Digital Breast Tomosynthesis Leads to Higher Cancer Detection Rate and Lower Recall

New BCSC findings suggest that using DBT leads to a higher cancer detection rate and lower recall rate compared to digital mammography.

Posted by Brian Sprague, PhD at 10:21 AM on Apr 1, 2020


Recent research findings, published in JAMA Network Open, and led by University of Vermont Cancer Center researcher Brian Sprague, PhD, Assistant Professor of Surgery, show that breast cancer screening with digital breast tomosynthesis (DBT, also known as 3D mammography) leads, overall, to higher cancer detection rates and lower recall rates for additional imaging compared with conventional digital mammography. In this Breast Cancer Surveillance Consortium cohort study, DBT was associated with an overall 15% decrease in recall rate and a 21% increase in cancer detection rate compared to digital mammography (DM).  The research team also looked at variation among radiologist interpretations of DBT screenings, and while most radiologists reduced recall rates through its use, not all did. Recall rates were significantly lower on DBT compared to DM exams interpreted prior to DBT use for 35.7% of radiologists and significantly higher for 14.3%; 50.0% had no statistically significant change in recall rate.  The researchers suggest that patients and healthcare providers can expect improved breast cancer screening performance with DBT vs. conventional digital mammography, but urge that radiology facilities should monitor radiologist performance with DBT to ensure that the benefits from DBT are realized.   The team’s findings are significant given that many US radiologists (close to 40%) have digital mammography recall rates far above the expert-recommended rate of 12%, resulting in costly and often unnecessary additional the frequent need for diagnostic imaging accompanied by patient anxiety.  DBT appears to allow radiologists to decrease their recall rate while maintaining or even improving their cancer detection rate.

Full Text Citation and Link: Sprague B.L; Coley R.Y.; Kerlikowske K.; . et al. Assessment of Radiologist Performance in Breast Cancer Screening Using Digital Breast Tomosynthesis vs. Digital Mammography. JAMA Netw Open. 2020;3(3):e201759. doi:10.1001/jamanetworkopen.2020.1759 [Link to Article]

These findings have been covered by the following media outlets:

University of Vermont Press Release: http://www.med.uvm.edu/com/news/2020/03/31/sprague_study_suggests_improved_breast_cancer_screening_with_3d_mammography

JAMA Network Open's Twitter Page: https://twitter.com/JAMANetworkOpen/status/1244746225460621314

UVM College of Medicine Twitter Page: https://twitter.com/UVMLarnerMed/status/1244752951844970496

DiagnosticImaging: https://www.diagnosticimaging.com/article/dbt-yields-lower-recall-rates-not-every-radiologist

HealthImaging: https://www.healthimaging.com/topics/womens-imaging/dbt-will-vary-substantially-depending-individual-radiologist

Aunt Minnie: https://www.auntminnie.com/index.aspx?sec=ser&sub=def&pag=dis&ItemID=128582

Posted by: Brian Sprague, PhD